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Abstract Objective To explore the characteristics of autonomic nerve function changes in patients with obstructive sleep apnea syndrome (OSAS) at different ages. Methods A total of 158 OSAS patients were selected, and divided into the young group (<40 years old, 38 cases), the middle-aged group (40-70 years old, 56 cases), and the elderly group (>70 years old, 64 cases) according to different ages. We selected 40 patients without OSAS who had been hospitalized during the same period as the control group. Patients in each group performed 24-hour ambulatory electrocardiography (AECG) monitoring. We recorded heart rate variability (HRV) time-domain indexes [standard deviation of all normal to normal RR intervals (SDNNDay, SDNNNight), standard deviation of all 5 minute normal RR intervals (SDANNDay, SDANNNight) and root mean square of successive differences in RR interval (rMSSDDay, rMSSDNight)\], and HRV frequencydomain indexes [low frequency power (LFDay, LFNight), high frequency power (HFDay, HFNight) and ratio of low frequency power to high frequency power (LFDay/HFDay, LFNight/HFNight)]. Results Neck circumference and body mass index in the elderly group are significantly higher than those in other groups (P<0.05). Apnea hypopnea index (AHI) in the young group is significantly higher than that in the control group; AHI in the middle-aged group is significantly higher than that in the control group and the young group; AHI in the elderly group is significantly higher than that in other groups (P<0.05). SDNNDay, SDNNNight, SDANNDay, SDANNNight, LFDay, LFNight, HFDay, LFDay/HFDay and LFNight/HFNight in the young, the middle-aged and the elderly group are significantly higher than those in the control group while rMSSDDay, rMSSDNight and HFNight are significantly lower than those in the control group (P<0.05). SDNNDay, SDNNNight, SDANNDay, SDANNNight, LFDay, LFNight, HFDay, LFDay/HFDay, LFNight/HFNight in the middle-aged group and the elderly group are significantly higher than those in the young group while rMSSDDay, rMSSDNight and HFNight are significantly lower than those in the young group (P<0.05). LFDay in the elderly group is significantly higher than that in the middle-aged group while HFNight is significantly lower than that in the middle-aged group (P<0.05). The incidence of arrhythmia in the middle-aged group and the elderly group is significantly higher than that in the young group while the incidence of arrhythmia in the elderly group is significantly higher than that in the middle-aged group (P<0.05). Pearson correlation analysis shows that the age of OSAS patients is positively correlated with SDNNDay, SDNNNight, SDANNDay, SDANNNight, LFDay, LFNight and HFDay, and is negatively correlated with rMSSDDay, rMSSDNight and HFNight. Conclusion The sympathetic nerve activity increases and the vagus nerve activity decreases among OSAS patients with age, and the imbalance between the sympathetic nerve and the vagus nerve becomes more obvious. AECG monitoring of HRV has guiding significance for the prevention and treatment of cardiovascular complications.
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