Time-varying closed-loop modeling of autonomic control in pediatric obstructive sleep apnea syndrome during cold face...

Area of Science:

• Pediatric cardiology
• Autonomic nervous system function
• Sleep medicine

Background:

• Obstructive sleep apnea syndrome (OSAS) is linked to autonomic dysfunction in adults.
• Autonomic effects in pediatric OSAS are less understood and potentially more subtle.
• Assessing autonomic function is crucial for understanding OSAS comorbidities in children.

Purpose of the Study:

• To quantify daytime autonomic dysfunction in children with OSAS using model-based analysis.
• To investigate the cardiovascular and autonomic responses to the cold face test (CFT) in pediatric OSAS.
• To differentiate autonomic responses between children with and without OSAS.

Main Methods:

• Utilized a model-based analysis approach to assess cardiovascular responses during the CFT.
• Measured transfer gain between respiration and R-R interval (RRI) in both groups.
• Quantified transfer gain between "surrogate cardiac output" and systolic blood pressure (SBP), and between cardiac output and SBP.

Main Results:

• No significant difference in transfer gain between respiration and RRI was observed between controls and OSAS.
• Transfer gains between cardiac output and SBP significantly increased in controls during CFT, but not in pediatric OSAS.
• Cardiovascular sympathetic reactivity, assessed via transfer gains, was impaired in children with OSAS.

Conclusions:

• Pediatric OSAS appears to have relatively preserved parasympathetic function.
• A significant impairment in cardiovascular sympathetic reactivity exists in children with OSAS.
• These findings highlight subtle but important autonomic alterations in pediatric OSAS.