A breath-by-breath and oscillation-by-oscillation analysis study: Holistic integrative interpretation of the respiratory-related circulatory parameter changes in OSA patients

Background: The disease OSA is common. The mechanism by which breathing pattern induces changes in circulatory parameters is still unclear. Based on the theory of Holistic Integrative Physiology, Medicine, this study aims to explain how respiration affects circulatory parameters during sleep. Methods: Our study included 18 normal subjects and 20 OSA patients (Apnea-Hypopnea Index ≥15) underwent standardized cardiopulmonary exercise testing (CPET) and polysomnography (PSG). We analyzed heart rate variability (HRV), systolic/diastolic blood pressure variability (SBPV/DBPV) and their percentage parameters using dual analytical approaches: Breath-by-Breath and Oscillation-by-Oscillation. Results: We found significant changes in respiratory and circulatory parameters during OSA sleep compared to those during normal respiratory sleep. HRV and HRV% were significantly higher in OSA patients (P = 0.004, P = 0.015). Systolic blood pressure and diastolic blood pressure were also significantly elevated. Anoscillation-by-oscillation study showed that abnormal OSA breathing patterns caused greater changes in the patient's circulatory parameters. Conclusions: Our study has shown that abnormal respiratorypatterns during sleep in OSA patients can significantly increase the variability of circulatory parameters, revealing that OSA may interfere with breathing patterns, affect changes in circulatory parameters.