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Cardiovascular changes in children with obstructive sleep apnea and obesity after treatment with noninvasive
Valerie G Kirk1, Heather Edgell2, Hitesh Joshi2
1Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada.
Insights
Noninvasive ventilation (NIV) for children with obesity and obstructive sleep apnea (OSA) slightly lowered heart rate and improved arousal-related heart rate variability, suggesting potential cardiovascular benefits.
Area of Science:
- Pediatric Cardiology
- Sleep Medicine
- Cardiovascular Risk Assessment
Background:
- Obesity and obstructive sleep apnea (OSA) in children increase cardiometabolic disease risk.
- Noninvasive ventilation (NIV) is a common treatment for OSA in children with obesity.
Purpose of the Study:
- To investigate the impact of NIV on heart rate variability (HRV) in children with obesity and newly diagnosed OSA.
- HRV serves as a marker for cardiovascular risk.
Main Methods:
- Prospective multicenter cohort study of children with obesity and moderate-severe OSA treated with NIV.
- HRV measured via polysomnography at baseline and 12 months.
- Analysis included sleep stages and events (arousal, desaturation).
Main Results:
- Twelve children completed the study.
- NIV treatment led to a 4.5 beats/min decrease in heart rate.
- No overall change in HRV parameters, but increased arousal-related sympathetic-parasympathetic balance observed.
Conclusions:
- NIV treatment in children with obesity and OSA shows small, potentially positive effects on cardiovascular risk.
- Observed changes include reduced heart rate and altered arousal-related autonomic balance.
Study Objectives:
Adults with obesity and obstructive sleep apnea (OSA) are at risk for cardiometabolic disease, and this risk likely extends to children with both conditions. Noninvasive ventilation (NIV; including continuous and bilevel positive airway pressure) is often used to treat OSA in children with obesity. The aim of this study was to examine the impact of NIV treatment on heart rate variability (HRV), as a marker of cardiovascular risk, in children with obesity and newly diagnosed OSA.
Methods:
A prospective multicenter cohort study was conducted in children with obesity prescribed NIV therapy for newly diagnosed moderate-severe OSA. Measurements of HRV were derived from polysomnography recordings at baseline and after 12 months of treatment. HRV parameters were examined by sleep stage, before and after arousal and oxygen desaturation events. HRV parameters were compared between time points using pair t tests as well as mixed model analysis.
Results:
Twelve children had appropriate data for analysis at baseline and 12 months. Heart rate decreased by 4.5 beats/min after NIV treatment, with no change in HRV parameters. HRV parameters differed by sleep stage and showed an increase in arousal-related sympathetic-parasympathetic balance after 12 months of NIV treatment. HRV parameters did not differ before and after oxygen desaturation events.
Conclusions:
NIV for the treatment in children with obesity and OSA resulted in a small decrease in heart rate and an increase in arousal-related sympathetic-parasympathetic balance. These findings suggest small, potentially positive impacts of NIV on cardiovascular risk in children with concurrent obesity and OSA.
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