A distinct ECG-derived spectrographic phenotype, designated as narrow-band elevated low frequency coupling (e-LFCNB)has been identified in a study in the July 1 issue of the journal
SLEEP. This biomarker is associated with prevalent hypertension, stroke, greater severity of sleep disordered breathing and sleep fragmentation in patients suffering from obstructive sleep apnea (OSA).
Results indicate that the odds ratio for prevalent stroke was 1.65 [CI: 1.19.29] in those with versus without the presence of e-LFCNB. The biomarker was detected in 1,233 participants (23.5 percent), with statistically significant differences between those with and without it. Patients with the biomarker tended to be older (average 64.7 years versus 61.4 years), male (63.3 percent versus 45.1 percent), slightly heavier (average body mass index 29.3 versus 28.6) and sleepier (according to the Epworth Sleepiness Score test results). Sleep apnea severity and use of diuretics, calcium blockers, and B-blockers were associated with increased e-LFCNB. After adjustment for age, sex, body mass index, hypertension, and diabetes, only prevalent stroke remained associated with both categorical and continuous measures of e-LFCNB, while treated and total hypertension were associated only with the ECG biomarker as continuous measure.
According to lead author Robert J. Thomas, MD, assistant professor of medicine at the Beth Israel Deaconess Medical Center & Harvard Medical School in Boston, Mass., the electrocardiogram (ECG)-based technique allows the tracking of interactions ("coupling") of breathing amplitude and heart-beat rate changes, which are both influenced by sleep, thus providing a 'map' of sleep behaviors. Use of this technique allows physicians to assign patients with sleep apnea into groups who have or do not have breathing control abnormalities.