Heart rate response to respiratory events with or without leg movements.

STUDY

OBJECTIVE

This study compares the heart rate responses to the termination of respiratory events, both with and without associated leg movements.

METHODS

Heart rate was measured for 15 R-R intervals before (T-15 to T-1) and after (T+1 to T+15) the termination of respiratory events as a change from the baseline rate, defined as the average of 10 R-R intervals occurring before the termination of each respiratory event (T-15 to T-6). Individual heart rate changes of the 21 patients were then averaged separately for 10 respiratory events with and 10 without associated leg movements.

SETTING

N/A.

PARTICIPANTS

Twenty-one patients with obstructive sleep apnea who had respiratory events both with and without associated leg movements.

INTERVENTION: N/A.

RESULTS

Maximal heart rate rise for respiratory events with leg movements (7.9 beats per minute) was significantly greater than for respiratory events without leg movements (5.1 beats per minute) (p < .0001). The area under the curve for heart rate increase from T-5 to T+9 was 50.1% higher for respiratory events with leg movements than without leg movements. When respiratory events with and without accompanying leg movements were compared, there were no significant differences in mean duration of respiratory events, mean oxygen desaturation after respiratory events, mean duration of electroencephalogram arousal following respiratory events, or mean heart rate during the baseline period. Heart rate rise did correlate with duration of the leg movements (p < .001) in those respiratory events with leg movements.

CONCLUSIONS

Cardiac activation is significantly greater when the termination of respiratory events is associated with leg movements compared to those without leg movements. This exaggerated heart rate response may be an independent consequence of the leg movements themselves, as other features of the respiratory events and associated arousal were not different in the two conditions.