Association between cyclic variation in the heart rate index and biomarkers of neurodegenerative diseases in obstructive sleep apnea syndrome: A pilot study

Cheng Yu Tsai, Yi Shin Liu, Arnab Majumdar, Robert Houghton, Shang Yang Lin, Yin Tzu Lin, Shu Chuan Ho, Wun Hao Cheng, Wen Te Liu, Dean Wu, Hsin Chien Lee, Yi Chun Kuan, Wei Han Hsu, Shin Mei Hsu, Chen Chen Lo, Po Chieh Chiu, You Rong Chen, Kang Lo, Chia I. Chen, Hsiang Jung LaiChun Yu Chen

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)


Purpose: Obstructive sleep apnea syndrome (OSAS) has mostly been examined using in-laboratory polysomnography (Lab-PSG), which may overestimate severity. This study compared sleep parameters in different environments and investigated the association between the plasma levels of neurochemical biomarkers and sleep parameters. Methods: Thirty Taiwanese participants underwent Lab-PSG while wearing a single-lead electrocardiogram patch. Participants’ blood samples were obtained in the morning immediately after the recording. Participants wore the patch for the subsequent three nights at home. Sleep disorder indices were calculated, including the apnea-hypopnea index (AHI), chest effort index, and cyclic variation of heart rate index (CVHRI). The 23 eligible participants’ derived data were divided into the normal-to-moderate (N-M) group and the severe group according to American Association of Sleep Medicine (AASM) guidelines (Lab-PSG) and the recommendations of a previous study (Rooti Rx). Spearman's correlation was used to examine the correlations between sleep parameters and neurochemical biomarker levels. Results: The mean T-Tau protein level was positively correlated with the home-based CVHRI (r = 0.53, p < 0.05), whereas no significant correlation was noted between hospital-based CVHRI and the mean T-tau protein level (r = 0.25, p = 0.25). The home-based data revealed that the mean T-Tau protein level in the severe group was significantly higher than that in the N-M group (severe group: 24.75 ± 6.16 pg/mL, N-M group: 19.65 ± 3.90 pg/mL; p < 0.05). Furthermore, the mean in-hospital CVHRI was higher than the mean at-home values (12.16 ± 13.66 events/h). Conclusion: Severe OSAS patients classified by home-based CVHRI demonstrated the higher T-Tau protein level, and CVHRI varied in different sleep environments.

Original languageEnglish
Pages (from-to)37-44
Number of pages8
JournalJournal of Clinical Neuroscience
Publication statusPublished - Apr 2022


  • Chest effort index
  • Cyclic variation of heart rate
  • In-laboratory polysomnography
  • Obstructive sleep apnea syndrome
  • T-Tau protein

ASJC Scopus subject areas

  • Surgery
  • Neurology
  • Clinical Neurology
  • Physiology (medical)


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