Comparison of pulse rate variability with heart rate variability during obstructive sleep apnea

• Published in: Medical engineering & physics Vol. 33; no. 2; pp. 204 - 209
• Main Authors: Khandoker, Ahsan H., Karmakar, Chandan K., Palaniswami, Marimuthu
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01.03.2011; Elsevier
• Subjects: Adult; Aged; Algorithms; Biological and medical sciences; Cardiovascular Physiological Phenomena; Electrocardiography - methods; Entropy; Heart Rate - physiology; Heart rate variability; Humans; Medical sciences; Middle Aged; Photoplethysmography - methods; Pneumology; Pulse; Pulse rate; Radiology; Respiration; Respiratory system : syndromes and miscellaneous diseases; Sleep - physiology; Sleep apnea; Sleep Apnea Syndromes - physiopathology; Sleep Apnea, Obstructive - physiopathology; Pulse rate; Heart rate variability; Sleep apnea; Human; Nervous system diseases; Sleep apnea syndrome; Respiratory disease; Variability; Pulse; Heart rate; Electrocardiography; Photoplethysmography; Comparative study; Biomedical engineering
• DOI: 10.1016/j.medengphy.2010.09.020
• ISSN: 1350-4533; 1873-4030

We investigate whether pulse rate variability (PRV) extracted from finger photo-plethysmography (Pleth) waveforms can be the substitute of heart rate variability (HRV) from RR intervals of ECG signals during obstructive sleep apnea (OSA). Simultaneous measurements (ECG and Pleth) were taken from 29 healthy subjects during normal (undisturbed sleep) breathing and 22 patients with OSA during OSA events. Highly significant ( p < 0.01) correlations (1.0 > r > 0.95) were found between heart rate (HR) and pulse rate (PR). Bland–Altman plot of HR and PR shows good agreement (<5% difference). Comparison of 2 min recording epochs demonstrated significant differences ( p < 0.01) in time, frequency domains and complexity analysis, between normal and OSA events using PRV as well as HRV measures. Results suggest that both HRV and PRV indices could be used to distinguish OSA events from normal breathing during sleep. However, several variability measures (SDNN, RMSSD, HF power, LF/HF and sample entropy) of PR and HR were found to be significantly ( p < 0.01) different during OSA events. Therefore, we conclude that PRV provides accurate inter-pulse variability to measure heart rate variability under normal breathing in sleep but does not precisely reflect HRV in sleep disordered breathing.