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Type: Journal article
Title: Altered nocturnal cardiovascular control in children with sleep-disordered breathing
Author: El-hamad, F.
Immanuel, S.
Liu, X.
Pamula, Y.
Kontos, A.
Martin, A.
Kennedy, J.
Kohler, M.
Porta, A.
Baumert, M.
Citation: Sleep, 2017; 40(10):1-9
Publisher: Oxford University Press
Issue Date: 2017
ISSN: 0161-8105
Statement of
Fatima El-Hamad, Sarah Immanuel, Xiao Liu, Yvonne Pamula, Anna Kontos, James Martin, Declan Kennedy, Mark Kohler, Alberto Porta, Mathias Baumert
Abstract: Study objectives: To assess cardiovascular control during sleep in children with sleep-disordered breathing (SDB) and the effect of adenotonsillectomy in comparison to healthy nonsnoring children. Methods: Cardiorespiratory signals obtained from overnight polysomnographic recordings of 28 children with SDB and 34 healthy nonsnoring children were analyzed. We employed an autoregressive closed-loop model with heart period (RR) and pulse transit time (PTT) as outputs and respiration as an external input to obtain estimates of respiratory gain and baroreflex gain. Results: Mean and variability of PTT were increased in children with SDB across all stages of sleep. Low frequency power of RR and PTT were attenuated during non–rapid eye movement (REM) sleep. Baroreflex sensitivity was reduced in children with SDB in stage 2 sleep, while respiratory gain was increased in slow wave sleep. After adenotonsillectomy, these indices normalized in the SDB group attaining values comparable to those of healthy children. Conclusions: In children with mild-to-moderate SDB, vasomotor activity is increased and baroreflex sensitivity decreased during quiet, event-free non-REM sleep. Adenotonsillectomy appears to reverse this effect.
Keywords: Baroreflex
cardiovascular control
heart rate
obstructive sleep apnea
Rights: © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved.
DOI: 10.1093/sleep/zsx127
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