Cardio-Respiratory Coordination Increases during Sleep Apnea

Maik Riedl, Andreas Muller, Jan F. Kraemer, Thomas Penzel, Jurgen Kurths, Niels Wessel

Research output: Contribution to journalArticlepeer-review

38 Citations (Scopus)
4 Downloads (Pure)


Cardiovascular diseases are the main source of morbidity and mortality in the United States with costs of more than $170
billion. Repetitive respiratory disorders during sleep are assumed to be a major cause of these diseases. Therefore, the
understanding of the cardio-respiratory regulation during these events is of high public interest. One of the governing
mechanisms is the mutual influence of the cardiac and respiratory oscillations on their respective onsets, the cardiorespiratory
coordination (CRC). We analyze this mechanism based on nocturnal measurements of 27 males suffering from
obstructive sleep apnea syndrome. Here we find, by using an advanced analysis technique, the coordigram, not only that
the occurrence of CRC is significantly more frequent during respiratory sleep disturbances than in normal respiration (pvalue,
10251) but also more frequent after these events (p-value,10215). Especially, the latter finding contradicts the
common assumption that spontaneous CRC can only be observed in epochs of relaxed conditions, while our newly
discovered epochs of CRC after disturbances are characterized by high autonomic stress. Our findings on the connection
between CRC and the appearance of sleep-disordered events require a substantial extension of the current understanding
of obstructive sleep apneas and hypopneas.
Original languageEnglish
Article number0093866
JournalPloS ONE
Issue number4
Publication statusPublished - Apr 2014


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