Minute-level ECG-derived autonomic dynamics around obstructive apnea events: A peri-event analysis of the PhysioNet apnea-ECG database

CONCLUSION: Obstructive apnea is associated with a reproducible minute-level autonomic signature of bradycardia and increased RR variability, with detectable shifts preceding scored event onset. Variability metrics, particularly SDNN, contribute more than mean heart rate. Findings require validation in cohorts with linked cardiovascular outcomes.