Acute cardiovascular changes with obstructive events in children with sleep disordered breathing
Denise M O'Driscoll1, Alison M Foster, Michelle L Ng
1Ritchie Centre for Baby Health Research, Monash Institute of Medical Research, Monash University, Victoria, Australia. denise.odriscoll@med.monash.edu.au
Sleep
|October 24, 2009
Summary
Children with sleep disordered breathing (SDB) experience significant increases in blood pressure (BP) and heart rate (HR) during obstructive events, similar to adults. These cardiovascular changes are more pronounced during non-rapid eye movement (NREM) sleep and arousal.
Area of Science:
- Pediatric cardiology
- Sleep medicine
- Cardiovascular physiology
Background:
- Obstructive sleep events in adults are linked to adverse cardiovascular outcomes.
- Children with sleep disordered breathing (SDB) face similar cardiovascular risks.
- Previous research indicates acute blood pressure (BP) and heart rate (HR) changes during obstructive apneas in adults.
Purpose of the Study:
- To investigate if BP and HR augment during obstructive events in children.
- To compare the magnitude of these changes in children to adult levels.
- To identify factors influencing cardiovascular changes during SDB events in pediatric populations.
Main Methods:
- Beat-by-beat mean arterial pressure (MAP) and HR were continuously monitored in 30 children (7-12 years) undergoing polysomnography.
- Data were analyzed across obstructive events (pre, early, late, post-event) during NREM and REM sleep.
- Two-way ANOVA with post hoc analyses compared cardiovascular changes, identifying predictors like sleep state and arousal.
Main Results:
- Significant increases in MAP and HR were observed from late to post-event during both NREM and REM sleep (P < 0.05).
- NREM sleep state and arousal from sleep were identified as significant independent predictors of the magnitude of cardiovascular change.
- The observed cardiovascular changes in children were comparable in magnitude to those reported in adult studies.
Conclusions:
- Pediatric SDB involves significant HR and BP fluctuations during obstructive events, mirroring adult responses.
- These acute cardiovascular changes are more pronounced during NREM sleep and associated with arousals.
- Repetitive cardiovascular perturbations in children with SDB may contribute to long-term cardiovascular complications, including hypertension.
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