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Treatment-Related Changes in Heart Rate Variability in Children with Sleep Apnea

Amal Isaiah1, Dylan Bertoni1, Kevin D Pereira1

  • 1Department of Otorhinolaryngology-Head and Neck Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|March 4, 2020
PubMed

Insights

Heart rate variability in children with obstructive sleep apnea is strongly influenced by average heart rate. Treatment for sleep apnea showed HRV changes, but not directly due to improved apnea severity.

Area of Science:

  • Pediatric cardiology
  • Sleep medicine
  • Autonomic nervous system function

Background:

  • Obstructive sleep apnea (OSA) in children can impact cardiac autonomic regulation, as indicated by heart rate variability (HRV).
  • The Childhood Adenotonsillectomy Trial (CHAT) provided data to investigate the relationship between OSA severity and HRV.
  • Understanding these connections is crucial for managing pediatric OSA and its cardiovascular implications.

Purpose of the Study:

  • To determine if treatment-related improvements in obstructive sleep apnea (OSA) severity causally affect heart rate variability (HRV) in children.
  • To identify the primary drivers of HRV changes in pediatric OSA patients undergoing treatment.

Main Methods:

  • Secondary analysis of data from the Childhood Adenotonsillectomy Trial (CHAT).
  • Evaluation of time- and frequency-domain HRV parameters, polysomnography (PSG) data, and demographic variables.
  • Quantification of the causal contribution of OSA severity (AHI, ODI) to HRV changes following early adenotonsillectomy (eAT).

Main Results:

  • Average heart rate during PSG was the most significant independent predictor of HRV parameters (P < .001).
  • Early adenotonsillectomy (eAT) led to statistically significant changes in most HRV parameters.
  • These observed HRV changes were not causally attributable to treatment-induced reductions in apnea-hypopnea index (AHI) or oxygen desaturation index (ODI).

Conclusions:

  • Average heart rate is a primary modulator of HRV in children with OSA.
  • While early adenotonsillectomy (eAT) impacts HRV, the effects are not directly caused by improvements in OSA severity metrics like AHI or ODI.
Abstract

Keywords:
heart rate variabilitypediatric obstructive sleep apneapolysomnography

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