Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/78510
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Type: Journal article
Title: Respiratory sinus arrhythmia during sleep in children with upper airway obstruction
Author: Kabir, M.
Kohler, M.
Pamula, Y.
Martin, A.
Kennedy, J.
Abbott, D.
Baumert, M.
Citation: Journal of Sleep Research, 2013; 22(4):463-470
Publisher: Blackwell Publishing Ltd
Issue Date: 2013
ISSN: 0962-1105
1365-2869
Statement of
Responsibility: 
Muammar M. Kabir, Mark Kohler, Yvonne Pamula, James Martin, Declan Kennedy, Derek Abbott and Mathias Baumert
Abstract: Upper airway obstruction during adulthood is associated with cardiovascular morbidity; cardiovascular consequences of childhood upper airway obstruction are less well established. This study aimed at investigating the effect of childhood upper airway obstruction on respiratory sinus arrhythmia as a measure of cardiac vagal modulation during night-time sleep. Overnight polysomnography was conducted in 40 healthy children (20 M; age: 7.5 ± 2.6 years; body mass index percentile: 60.7 ± 26.4%) and 40 children with upper airway obstruction (24 M; age: 7.5 ± 2.7 years; body mass index percentile: 65.8 ± 31.9%). We used the phase-averaging technique to compute respiratory sinus arrhythmia amplitude and phase delay. To study sleep stage effects and the effect of upper airway obstruction, respiratory sinus arrhythmia was measured during all artefact-free sleep episodes, and after exclusion of respiratory events. A significant increase in respiratory sinus arrhythmia amplitude and phase delay was observed during stage 4 sleep as compared with rapid eye movement sleep in both groups (amplitude: controls = 0.10 ± 0.03 versus 0.07 ± 0.02 s, P < 0.01, respectively, and upper airway obstruction = 0.07 ± 0.03 versus 0.05 ± 0.03 s, P < 0.05, respectively; phase delay: controls = 3.1 ± 0.1 versus 3.0 ± 0.1 rad, P < 0.05, respectively, and upper airway obstruction = 3.13 ± 0.04 versus 3.04 ± 0.08 rad, P < 0.01, respectively). A significant association between respiratory sinus arrhythmia and apnoea/hypopnoea index was observed during stage 2 sleep in children with upper airway obstruction. Compared with healthy controls, a significant decrease in respiratory sinus arrhythmia amplitude during stage 2 sleep was observed in children with upper airway obstruction (0.09 ± 0.03 versus 0.06 ± 0.03 s, P < 0.05). However, this difference was not apparent when respiratory events were excluded from analysis. Importantly, respiratory sinus arrhythmia showed a strong negative correlation with body mass index. In conclusion, night-time respiratory sinus arrhythmia in children is sleep stage dependent and normal during quiet sleep in children with relatively mild upper airway obstruction.
Keywords: autonomic control; breathing frequency; heart; heart rate variability; respiration
Rights: © 2013 European Sleep Research Society
RMID: 0020124729
DOI: 10.1111/jsr.12036
Appears in Collections:Electrical and Electronic Engineering publications

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