Nocturnal Physiological Burden in Sleep-Disordered Breathing: Measurement, Phenotyping, and Cardiovascular Outcomes

The apnea-hypopnea index has served for decades as the standard summary of sleep-disordered breathing, yet it counts events and says little about what the body actually endures overnight. The depth and duration of hypoxemia, arousal, autonomic activation and hemodynamic swings accumulate across the night, and a growing body of evidence suggests this physiological burden tracks cardiovascular risk more closely than event frequency does.Progress has been uneven. Measures of nocturnal burden are defined differently across studies, phenotyping approaches are still being established, and the pathways linking overnight physiology to vascular and cardiac injury remain only partly understood. Treatment trials have often returned neutral results, which raises the question of whether patients have been selected on the wrong measure.This Research Topic invites methodological, mechanistic, translational, and clinical contributions across this continuum. Topics of interest include, but are not limited to:- Definitions, standardization, and comparative prognostic value of nocturnal hypoxic and multidimensional physiological burden- Signal-processing and measurement approaches using polysomnography, cardiorespiratory polygraphy, wearable sensors, and home-based monitoring- Physiological and clinical phenotyping, endotyping, and subgroup identification, including data-driven methods- Mechanisms linking nocturnal physiological stress to vascular dysfunction, myocardial injury, remodeling, and arrhythmogenesis- Cardiovascular risk stratification and long-term outcomes beyond conventional event-frequency measures- Sleep-disordered breathing in cardiovascular populations, including hypertension, coronary artery disease, heart failure, arrhythmias, pulmonary vascular disease, and stroke- Treatment response and the identification of patients most likely to benefit from targeted interventions Topic editors: Zhihua Huang, Thomas Penzel, Robert J Thomas Source: https://www.frontiersin.org/research-topics/85574/nocturnal-physiological-burden-in-sleep-disordered-breathing-measurement-phenotyping-and-cardiovascular-outcomes