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Abnormalities in autonomic function in obese boys at-risk for insulin resistance and obstructive sleep apnea

Flavia M S Oliveira1, Winston H Tran2, Daniel J Lesser3

  • 1Department of Electrical Engineering, University of Brasilia, Brasilia, Brazil. flavia@ene.unb.br.

Pediatric Research
|November 14, 2018
PubMed

Insights

Obstructive sleep apnea (OSA) in obese children is linked to autonomic dysfunction and impaired glucose metabolism. Metabolic dysfunction, not OSA severity, significantly impacts vascular sympathetic activity and vagal function.

Area of Science:

  • Pediatric Endocrinology
  • Sleep Medicine
  • Cardiovascular Physiology

Background:

  • Obstructive sleep apnea (OSA) is associated with autonomic dysfunction and glucose metabolism issues in adults.
  • These relationships are less understood in obese children.

Purpose of the Study:

  • To investigate the associations among obstructive sleep apnea (OSA), glucose metabolism, and daytime autonomic function in obese pediatric subjects.

Main Methods:

  • Overnight polysomnography was performed on 23 obese boys.
  • Frequently sampled intravenous glucose tolerance tests assessed glucose metabolism.
  • Cardiorespiratory data were recorded in supine and standing postures to evaluate autonomic function.

Main Results:

  • Insulin resistance, elevated fasting glucose, and reduced beta-cell function correlated with blood pressure and heart rate variability reactivity, independent of OSA severity.
  • Reduced baroreflex sensitivity reactivity was observed with sleep fragmentation in participants with impaired insulin sensitivity.

Conclusions:

  • Metabolic dysfunction, rather than OSA severity, more significantly impacts vascular sympathetic activity in obese children.
  • Blunted vagal autonomic function due to sleep fragmentation in OSA is exacerbated by co-existing metabolic dysfunction.
Abstract

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