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Measuring Cardiac Autonomic Nervous System (ANS) Activity in Toddlers - Resting and Developmental Challenges
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Cardiac and sympathetic activation are reduced in children with Down syndrome and sleep disordered breathing

Denise M O'Driscoll1, Rosemary S C Horne, Margot J Davey

  • 1The Ritchie Centre, Monash Institute of Medical Research, Monash University, Victoria, Australia. denise.odriscoll@monash.edu

Sleep
|September 4, 2012
PubMed

Insights

Children with Down syndrome (DS) and sleep disordered breathing (SDB) show a weaker cardiovascular and sympathetic response to breathing events compared to typically developing children. This may explain their higher risk for conditions like pulmonary hypertension.

Area of Science:

  • Pediatric Cardiology
  • Sleep Medicine
  • Genetics

Background:

  • Sleep disordered breathing (SDB) is more common in children with Down syndrome (DS).
  • The cardiovascular and sympathetic responses to SDB in children with DS are not well understood.
  • This may contribute to increased risk of pulmonary hypertension in this population.

Purpose of the Study:

  • To compare the cardiovascular and sympathetic responses to obstructive respiratory events in children with DS and SDB versus typically developing (TD) children with SDB.
  • To investigate potential mechanisms for the increased risk of pulmonary hypertension in children with DS.

Main Methods:

  • Overnight polysomnography and urine collection were performed on 64 children (32 DS, 32 TD) aged 2-17 years with SDB.
  • Beat-by-beat heart rate (HR) changes during obstructive events were analyzed.
  • Oxygen re-saturation times and overnight urinary catecholamine levels (noradrenaline, adrenaline, dopamine) were compared between groups.

Main Results:

  • Children with DS had significantly reduced HR changes post-event during NREM sleep compared to TD children.
  • The time for oxygen re-saturation after events was significantly longer in children with DS.
  • Children with DS exhibited significantly lower overnight urinary levels of noradrenaline, adrenaline, and dopamine.

Conclusions:

  • Children with DS and SDB have a blunted cardio-respiratory and sympathetic response to obstructive events.
  • These findings suggest autonomic dysfunction in children with DS, potentially increasing their risk for cardiovascular complications like pulmonary hypertension.
Abstract

Keywords:
Down syndromeapneaheart ratehypopneaoxygen saturationsleep disordered breathingsympathetic

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