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Rhythm disturbances in childhood obstructive sleep apnea during apnea-hypopnea episodes

Anant Khositseth1, Jittamas Chokechuleekorn, Teeradej Kuptanon

  • 1Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

Annals of Pediatric Cardiology
|April 30, 2013
PubMed

Insights

Children with obstructive sleep apnea (OSA) showed no significant arrhythmias during sleep. However, heart rate variability during REM sleep increased with OSA severity, indicating a link between sleep apnea and cardiac function in pediatric patients.

Area of Science:

  • Pediatric Cardiology
  • Sleep Medicine
  • Cardiovascular Complications

Background:

  • Obstructive sleep apnea (OSA) is linked to cardiovascular issues in adults, with up to 50% experiencing nocturnal arrhythmias.
  • Cardiac rhythm disturbances and heart rate variability in children with OSA remain understudied.
  • Investigating these factors in pediatric OSA is crucial for understanding potential long-term health impacts.

Purpose of the Study:

  • To investigate cardiac rhythm disturbances in children diagnosed with OSA.
  • To analyze the relationship between heart rate variability (HRV) and the severity of OSA in pediatric patients.
  • To assess potential cardiovascular risks associated with childhood OSA.

Main Methods:

  • Retrospective cross-sectional study analyzing polysomnography (PSG) data from children under 15 with suspected OSA.
  • Cardiac rhythm and heart rate variability were monitored during PSG.
  • Patients were categorized into mild, moderate, and severe OSA groups based on PSG findings.

Main Results:

  • All 124 children diagnosed with OSA exhibited sinus arrhythmias during sleep; only three had premature atrial contractions (PACs).
  • Significant differences in standard deviation of heart rate (SD-HR) during REM sleep were observed between severe and mild OSA groups (9.1 ± 2.4 vs. 7.5 ± 1.3, P < 0.0001).
  • Maximum heart rate (max-HR) during REM sleep was also significantly higher in severe OSA compared to mild OSA (132.1 ± 22.1 bpm vs. 121.3 ± 12.6 bpm, P = 0.016).

Conclusions:

  • Pediatric OSA patients did not exhibit significant arrhythmias during sleep.
  • Heart rate variability parameters, specifically during REM sleep, demonstrated a correlation with the severity of OSA in children.
  • These findings suggest that while overt arrhythmias are rare, altered heart rate variability may indicate underlying cardiovascular stress in pediatric OSA.
Abstract

Keywords:
Arrhythmiachildrenobstructive sleep apnea

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