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Pulse wave amplitude and heart period variability in children with upper airway obstruction

X Liu1, S A Immanuel1, Y Pamula2

  • 1University of Adelaide, School of Electrical and Electronic Engineering, Adelaide, SA5005, Australia.

Sleep Medicine
|July 9, 2018
PubMed

Insights

Children with upper airway obstruction (UAO) exhibit altered cardiovascular autonomic modulation, even during event-free sleep. Adenotonsillectomy (AT) treatment effectively reversed these autonomic changes, improving sleep patterns.

Area of Science:

  • Pediatric Sleep Medicine
  • Cardiovascular Physiology
  • Autonomic Nervous System Function

Background:

  • Upper airway obstruction (UAO) in children, often associated with snoring, can impact physiological regulation.
  • Cardiovascular autonomic modulation plays a critical role in maintaining homeostasis during sleep.
  • Understanding these effects is crucial for identifying potential interventions.

Purpose of the Study:

  • To evaluate cardiovascular autonomic modulation in children diagnosed with mild-to-moderate UAO.
  • To compare autonomic modulation patterns between children with UAO and non-snoring controls.
  • To investigate the impact of adenotonsillectomy (AT) on autonomic modulation in children with UAO.

Main Methods:

  • Utilized overnight polysomnographic (PSG) recordings to obtain ECG and finger photoplethysmographic signals.
  • Analyzed heart period (HP) and pulse wave amplitude (PWA) using symbolic analysis during NREM and REM sleep.
  • Assessed joint dynamics of PWA and HP to quantify cardiovascular autonomic modulation.

Main Results:

  • Children with UAO demonstrated increased monotonic HP patterns during NREM sleep compared to controls.
  • Elevated monotonic joint PWA-HP patterns were observed in both NREM and REM sleep in children with UAO.
  • Following adenotonsillectomy (AT), significant alterations in HP and joint PWA-HP dynamics were noted, moving towards control group levels.

Conclusions:

  • Mild-to-moderate UAO is associated with heightened cardiovascular autonomic modulation, persisting even during sleep without discrete respiratory events.
  • Adenotonsillectomy (AT) demonstrates a potential to reverse the observed patterns of autonomic dysregulation in children with UAO.
Abstract

Keywords:
AdenotonsillectomyAutonomic activationCardiovascular controlHeart ratePulse wave amplitudeUpper airway obstruction

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