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While long-term cardiac effects are understood, the immediate impact of hypoxaemia on the heart's electrophysiology lacks understanding. Our study aims to explore desaturation severity on cardiovascular repolarisation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively analysed ECGs from full diagnostic polysomnographies from 492 patients with suspected OSA. The analyses were conducted before, during and after 9137 nocturnal apnoea- or hypopnoea-related desaturations. The mean and<jats:sc>sd<\/jats:sc>of T-wave amplitude change from the baseline level to the level during and after desaturations (\u0394T<jats:sub>amp_mean<\/jats:sub>and \u0394T<jats:sub>amp_SD<\/jats:sub>) were calculated. To investigate the modulatory effects of desaturation severity, the data were divided into subgroups based on the desaturation duration (T<jats:sub>des<\/jats:sub>; 10\u2005s\u2264T<jats:sub>des<\/jats:sub>&lt;20\u2005s, 20\u2005s\u2264T<jats:sub>des<\/jats:sub>&lt;30\u2005s, 30\u2005s\u2264T<jats:sub>des<\/jats:sub>&lt;45\u2005s and T<jats:sub>des<\/jats:sub>\u226545\u2005s) and magnitude of blood oxygen saturation drop (change in peripheral oxygen saturation (\u0394<jats:italic>S<\/jats:italic><jats:sub>pO<jats:sub>2<\/jats:sub><\/jats:sub>); 3%\u2264\u0394<jats:italic>S<\/jats:italic><jats:sub>pO<jats:sub>2<\/jats:sub><\/jats:sub>&lt;4.5%, 4.5%\u2264\u0394<jats:italic>S<\/jats:italic><jats:sub>pO<jats:sub>2<\/jats:sub><\/jats:sub>&lt;6%, 6%\u2264\u0394<jats:italic>S<\/jats:italic><jats:sub>pO<jats:sub>2<\/jats:sub><\/jats:sub>&lt;7.5% and \u0394<jats:italic>S<\/jats:italic><jats:sub>pO<jats:sub>2<\/jats:sub><\/jats:sub>\u22657.5%) for men and women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Desaturations caused significant (p&lt;0.01) changes in \u0394T<jats:sub>amp_mean<\/jats:sub>during and after desaturations. In men, the median \u0394T<jats:sub>amp_mean<\/jats:sub>during and after deep (\u0394<jats:italic>S<\/jats:italic><jats:sub>pO<jats:sub>2<\/jats:sub><\/jats:sub>\u22657.5%) desaturations were 21\u2005\u00b5V and 24\u2005\u00b5V, respectively. In women, the median \u0394T<jats:sub>amp_mean<\/jats:sub>in deep desaturations was 15\u2005\u00b5V during and 21\u2005\u00b5V after desaturations. Similarly, the \u0394T<jats:sub>amp_SD<\/jats:sub>increased during and after deep desaturations. In regression analysis, the desaturation depth was an independent predictor for ventricular repolarisation instability.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We found an association between the severity of nocturnal desaturations and cardiac repolarisation instability. These findings hold particular importance, as repolarisation instability has been linked with cardiovascular morbidity and could potentially serve as a trigger for arrhythmias and sudden cardiac death.<\/jats:p><\/jats:sec>","DOI":"10.1183\/23120541.00341-2024","type":"journal-article","created":{"date-parts":[[2024,7,4]],"date-time":"2024-07-04T15:30:19Z","timestamp":1720107019000},"page":"00341-2024","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Hypoxaemic load in sleep apnoea is associated with acute changes in T-wave amplitude"],"prefix":"10.1183","volume":"10","author":[{"given":"Saara","family":"Sillanm\u00e4ki","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Serajeddin","family":"Ebrahimian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5355-6203","authenticated-orcid":false,"given":"Salla","family":"Hietakoste","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Hernando","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raquel","family":"Bailon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timo","family":"Lepp\u00e4nen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2798-2115","authenticated-orcid":false,"given":"Samu","family":"Kainulainen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"81","published-online":{"date-parts":[[2024,7,4]]},"reference":[{"key":"2024102804150920000_10.5.00341-2024.1","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1016\/S2213-2600(19)30198-5","article-title":"Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis","volume":"7","author":"Benjafield","year":"2019","journal-title":"Lancet Respir Med"},{"key":"2024102804150920000_10.5.00341-2024.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa041832"},{"key":"2024102804150920000_10.5.00341-2024.3","first-page":"1071","article-title":"Sleep disordered breathing and mortality: eighteen-year follow-up of the Wisconsin sleep cohort","volume":"31","author":"Young","year":"2008","journal-title":"Sleep"},{"key":"2024102804150920000_10.5.00341-2024.4","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-013-0927-z"},{"key":"2024102804150920000_10.5.00341-2024.5","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy624"},{"key":"2024102804150920000_10.5.00341-2024.6","doi-asserted-by":"crossref","first-page":"e006942","DOI":"10.1161\/CIRCEP.118.006942","article-title":"Cardiac afferent denervation abolishes ganglionated plexi and sympathetic responses to apnea: implications for atrial fibrillation","volume":"12","author":"Tavares","year":"2019","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"2024102804150920000_10.5.00341-2024.7","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1186\/s12890-022-01996-y","article-title":"QTc prolongation is associated with severe desaturations in stroke patients with sleep apnea","volume":"22","author":"Sillanm\u00e4ki","year":"2022","journal-title":"BMC Pulm Med"},{"key":"2024102804150920000_10.5.00341-2024.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.06.029"},{"key":"2024102804150920000_10.5.00341-2024.9","doi-asserted-by":"publisher","DOI":"10.1136\/heart.85.4.385"},{"key":"2024102804150920000_10.5.00341-2024.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.08.066"},{"key":"2024102804150920000_10.5.00341-2024.11","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199401273300402"},{"key":"2024102804150920000_10.5.00341-2024.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2007.03.069"},{"key":"2024102804150920000_10.5.00341-2024.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.11.026"},{"key":"2024102804150920000_10.5.00341-2024.14","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000143160.14610.53"},{"key":"2024102804150920000_10.5.00341-2024.15","unstructured":"Berry RB , Brooks R , Gamaldo CE , et al. 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