Nocturnal autonomic function in preschool children with sleep-disordered breathing

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Measuring Cardiac Autonomic Nervous System (ANS) Activity in Toddlers - Resting and Developmental Challenges
08:22

Measuring Cardiac Autonomic Nervous System (ANS) Activity in Toddlers - Resting and Developmental Challenges

Published on: February 25, 2016

Lauren C Nisbet1, Stephanie R Yiallourou, Gillian M Nixon

  • 1The Ritchie Centre, Monash Institute of Medical Research, Monash University, Melbourne, Australia.

Sleep Medicine
|October 5, 2013
PubMed

Insights

Obstructive sleep apnea (OSA) in preschoolers is linked to altered heart rate variability (HRV), particularly higher high-frequency (HF) HRV. Early treatment may prevent severe autonomic dysfunction.

Area of Science:

  • Pediatric Pulmonology
  • Sleep Medicine
  • Autonomic Nervous System Function

Background:

  • Obstructive sleep apnea (OSA) is known to cause autonomic dysfunction in older individuals.
  • This association has not been previously studied in preschool-aged children.
  • Investigating this link in young children is crucial for early intervention.

Purpose of the Study:

  • To analyze heart rate variability (HRV) and catecholamine levels in preschool children with OSA.
  • To determine if OSA in preschoolers is associated with autonomic dysfunction.
  • To identify potential early markers of OSA-related autonomic changes.

Main Methods:

  • Overnight polysomnography (PSG) was performed on 142 snoring children (3-5 years) and 38 controls.
  • Children were categorized by obstructive apnea-hypopnea index (OAHI) into control, primary snoring, mild OSA, and moderate to severe (MS) OSA groups.
  • Heart rate variability (HRV) parameters were averaged during REM and NREM sleep; nocturnal urinary catecholamines were measured.

Main Results:

  • The MS OSA group exhibited significantly higher high-frequency (HF) HRV compared to controls across all sleep stages.
  • The MS OSA group showed a lower low-frequency/high-frequency (LF/HF) ratio during all sleep stages.
  • No significant differences in catecholamine levels were observed between groups.

Conclusions:

  • Preschool OSA is associated with altered HRV, characterized by increased HF fluctuations, even during stable sleep.
  • These HRV changes suggest developing autonomic dysfunction in preschool children with OSA.
  • Preschool age may be a critical window for OSA treatment to prevent long-term autonomic complications.
Abstract

Keywords:
Autonomic nervous systemCatecholaminesHeart rateHeart rate variabilityPediatricSleep disordered breathing

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