Altered Nocturnal Cardiovascular Control in Children With Sleep-Disordered Breathing

Fatima El-Hamad, Sarah Immanuel, Xiao Liu, Yvonne Pamula, Anna Kontos, James Martin, Declan Kennedy, Mark Kohler, Alberto Porta, Mathias Baumert

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
JournalSleep
Volume40
Issue number10
DOIs
Publication statusPublished - Oct 1 2017

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