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Published on: June 5, 2019
Heart rate variability in pediatric obstructive sleep apnea.
Zhi-De Deng1, Chi-Sang Poon, Natalia M Arzeno
1Dept. of Electr. Eng. & Comput. Sci., Massachusetts Inst. of Technol., Cambridge, MA 02139, USA. zzzdeng@mit.edu
Summary
Heart rate variability (HRV) analysis shows potential for diagnosing obstructive sleep apnea syndrome (OSAS) in children. Numerical titration during REM sleep demonstrated higher accuracy in identifying OSAS, suggesting its utility as a non-invasive screening tool.
Area of Science:
- Pediatrics
- Cardiology
- Sleep Medicine
Background:
- Obstructive sleep apnea syndrome (OSAS) affects about 2% of children.
- Heart rate variability (HRV) is a non-invasive method for assessing autonomic nervous system function.
- Current diagnostic methods for pediatric OSAS can be invasive or complex.
Purpose of the Study:
- To investigate the diagnostic potential of HRV using various nonlinear techniques for pediatric OSAS.
- To evaluate the influence of sleep stages (REM and NREM) on HRV parameters in children with and without OSAS.
- To determine if HRV analysis can serve as a simple screening tool for pediatric OSAS.
Main Methods:
- Power spectral analysis, numerical titration, sample entropy, and detrended fluctuation analysis of HRV were employed.
- Data were analyzed separately for REM and NREM sleep stages.
- Receiver-operating characteristic (ROC) analysis was used to assess diagnostic performance.
Main Results:
- Heart rate chaos intensity (numerical titration noise limit) was significantly higher during REM sleep compared to NREM sleep across all patient groups.
- The numerical-titration technique achieved a specificity of 72.2% and a sensitivity of 81.3% for OSAS detection.
- Sleep state significantly influences cardiac autonomic control in children.
Conclusions:
- Nonlinear HRV analysis, particularly numerical titration, shows promise as an effective screening tool for pediatric OSAS.
- Sleep state (REM vs. NREM) is a critical factor in interpreting HRV for OSAS diagnosis.
- Combining spectral analysis with nonlinear techniques like numerical titration may enhance diagnostic accuracy for pediatric OSAS.
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