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Autonomic cardiovascular control in children with obstructive sleep apnea
Insights
Children with obstructive sleep apnea (OSA) show heightened sympathetic nervous system activity and an imbalanced autonomic nervous system (ANS) across all sleep-wake states, impacting cardiorespiratory control.
Area of Science:
- Cardiorespiratory control
- Autonomic nervous system (ANS) function
- Pediatric sleep medicine
Background:
- Autonomic cardiorespiratory control varies with sleep-wake states.
- Sleep-related breathing disorders significantly influence autonomic function.
- Power spectrum (PS) analysis of heart rate (HR) fluctuations assesses autonomic nervous system (ANS) roles.
Purpose of the Study:
- To investigate autonomic cardiorespiratory control in children diagnosed with obstructive sleep apnea (OSA) syndrome.
- To compare ANS function between children with OSA and healthy controls during various sleep-wake states.
Main Methods:
- Studied 10 children with OSA and 10 healthy controls.
- Utilized whole-night polysomnography for data acquisition.
- Performed spectral analysis on heart rate (HR) and breathing signals during artifact-free epochs.
Main Results:
- The low-frequency (LF) power component was elevated in the OSA group across all states, indicating increased sympathetic activity.
- Sympathetic predominance was observed during REM sleep in all subjects.
- Parasympathetic predominance occurred during slow-wave sleep exclusively in controls.
- The autonomic balance (LF/HF ratio) was significantly higher in OSA patients compared to controls throughout the night and before sleep onset.
Conclusions:
- Children with OSA exhibit enhanced sympathetic activity and a heightened autonomic balance (LF/HF ratio) compared to healthy children.
- The computed autonomic balance index (ABI) demonstrated a strong correlation with the respiratory disturbance index (RDI).
- Findings suggest a significant disruption of autonomic cardiorespiratory control in pediatric OSA.
Abstract:
Autonomic cardiorespiratory control changes with sleep-wake states and is influenced by sleep-related breathing disorders. Power spectrum (PS) analysis of instantaneous fluctuations in heart rate (HR) is used to investigate the role of the autonomic nervous system (ANS) in cardiorespiratory control. The two spectral regions of interest are the low frequency component (LF) and high frequency component (HF). The aim of the present study was to investigate the autonomic cardiorespiratory control in children with obstructive sleep apnea (OSA) syndrome. We studied 10 children with OSA versus 10 normal children. All subjects underwent whole night polysomnography. Spectral analysis of the HR and breathing signals was performed for 256 second long, artifact-free epochs in each sleep-wake state. The LF power was higher in the OSA group compared with control subjects for all states, reflecting enhanced sympathetic activity in OSA subjects. The results indicated sympathetic predominance during REM sleep in all subjects and parasympathetic predominance in slow wave sleep only in controls. The autonomic balance (LF/HF) was significantly higher in OSA patients than in control subjects, at all stages during night sleep, and while awake before sleep onset. An index of overall autonomic balance (ABI) was computed for each subject and correlated well with the measured respiratory disturbance index (RDI).