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Sleep disordered breathing and autonomic function in overweight and obese children and adolescents

Annelies Van Eyck1, Kim Van Hoorenbeeck1, Benedicte Y De Winter2

  • 1Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp, Belgium; Dept of Paediatrics, Antwerp University Hospital, Edegem, Belgium.

ERJ Open Research
|December 22, 2016
PubMed

Insights

Children with obesity and obstructive sleep apnoea (OSA) show increased sympathetic heart activity. Intermittent hypoxia, linked to lower oxygen levels, appears to drive this autonomic dysfunction.

Area of Science:

  • Pediatric Cardiology
  • Sleep Medicine
  • Autonomic Neuroscience

Background:

  • Obstructive sleep apnoea (OSA) is prevalent in children with obesity and linked to cardiovascular issues.
  • Autonomic dysfunction is a suspected mechanism behind these cardiovascular complications.
  • Understanding the interplay between obesity, OSA, and sympathetic activity in children is crucial.

Purpose of the Study:

  • To investigate the relationship between obesity, obstructive sleep apnoea (OSA), and sympathetic nervous system activity in children.
  • To determine if OSA exacerbates autonomic dysfunction in obese children.
  • To explore the role of intermittent hypoxia in this relationship.

Main Methods:

  • Analysis of heart rate variability (HRV) using beat-to-beat RR interval data from polysomnography in 191 children with obesity (60 with OSA, 131 controls).
  • Measurement of urinary free cortisol levels.
  • Correlation analysis between HRV measures, OSA severity (oxygen desaturation index), oxygen saturation (SpO2), and obesity parameters.

Main Results:

  • No significant difference in urinary free cortisol levels between groups.
  • Children with OSA exhibited decreased mean RR interval and increased mean heart rate and low/high-frequency band ratio, indicating heightened sympathetic activity.
  • HRV measures correlated significantly with OSA severity and hypoxia, independent of obesity and age.

Conclusions:

  • Children with obesity and OSA demonstrate increased sympathetic heart activity.
  • Intermittent hypoxia, a hallmark of OSA, is associated with increased sympathetic tone and autonomic dysfunction.
  • These findings highlight the autonomic impact of OSA in obese children, potentially contributing to cardiovascular morbidity.

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