Contribution of ECG Holter recordings for the diagnosis of sleep apnea syndrome in patients with massive obesity

OBJECTIVE: Assess the diagnostic contribution of cyclic nocturnal variation s in heart rate in sleep apnea syndrome. PATIENTS AND METHODS: Holter recordings performed in a population of 30 pat ients with massive obesity defined as a body mass index greater than 40 kg/ m(2) and steep apnea syndrome defined by an apnea index greater than 5 apne as per hour were analyzed retrospectively. The control group was composed o f 15 patients with massive obesity but without sleep apnea syndrome. High v ariability in nocturnal heart rate was assessed using a visual criterion de fined as repeated episodes of progressive reduction in heart rate followed by a sudden acceleration reaching a difference of 30 bpm between the highes t and lowest heart rate and occurring at least 5 times during one consecuti ve hour of recording. RESULTS: Increased nocturnal variability in heart rate was evidenced in all the patients with sleep apnea syndrome (30/30) but was not observed in any of the control subjects (0/15). CONCLUSION: These results suggest that Hotter recordings can be a useful to ol for the diagnosis of sleep apnea syndrome.