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Heart rate variability spectrum characteristics in children with sleep apnea
Adrián Martín-Montero1, Gonzalo C Gutiérrez-Tobal2,3, Leila Kheirandish-Gozal4
1Biomedical Engineering Group, University of Valladolid, Valladolid, Spain. adrian.martin@gib.tel.uva.es.
Insights
New heart rate variability (HRV) spectral bands offer better detection of pediatric sleep apnea-hypopnea syndrome (SAHS). These novel bands improve characterization of SAHS effects on cardiac function and may serve as biomarkers.
Area of Science:
- Pediatric cardiology
- Sleep medicine
- Biomedical signal processing
Background:
- Classic spectral analysis of heart rate variability (HRV) in pediatric sleep apnea-hypopnea syndrome (SAHS) uses standard frequency bands (VLF, LF, HF).
- Specific SAHS-related frequency bands within HRV have not been previously explored.
Purpose of the Study:
- To define and characterize novel HRV spectral bands specific to pediatric SAHS.
- To assess the diagnostic ability of these new bands compared to traditional HRV analysis.
Main Methods:
- Utilized overnight HRV recordings from 1,738 children (0-13 years) across two databases.
- Defined new pediatric SAHS-related frequency bands using a training set.
- Computed relative power in new bands and assessed relationships with polysomnographic variables in a test set.
Main Results:
- Identified two new specific spectral bands (0-0.15 Hz) related to apneic event duration, awakenings, and wakefulness after sleep onset (WASO).
- Found an adaptive band within the high frequency (HF) range related to oxyhemoglobin desaturations, arousals, and WASO.
- Demonstrated superior diagnostic ability of the novel spectral bands compared to classic HRV analysis.
Conclusions:
- Novel spectral bands provide enhanced characterization of pediatric SAHS.
- These findings may improve understanding of SAHS impact on cardiac function.
- New spectral bands show potential as detection biomarkers for pediatric SAHS.
Background:
Classic spectral analysis of heart rate variability (HRV) in pediatric sleep apnea-hypopnea syndrome (SAHS) traditionally evaluates the very low frequency (VLF: 0-0.04 Hz), low frequency (LF: 0.04-0.15 Hz), and high frequency (HF: 0.15-0.40 Hz) bands. However, specific SAHS-related frequency bands have not been explored.
Methods:
One thousand seven hundred and thirty-eight HRV overnight recordings from two pediatric databases (0-13 years) were evaluated. The first one (981 children) served as training set to define new HRV pediatric SAHS-related frequency bands. The associated relative power (RP) were computed in the test set, the Childhood Adenotonsillectomy Trial database (CHAT, 757 children). Their relationships with polysomnographic variables and diagnostic ability were assessed.
Results:
Two new specific spectral bands of pediatric SAHS within 0-0.15 Hz were related to duration of apneic events, number of awakenings, and wakefulness after sleep onset (WASO), while an adaptive individual-specific new band from HF was related to oxyhemoglobin desaturations, arousals, and WASO. Furthermore, these new spectral bands showed improved diagnostic ability than classic HRV.
Conclusions:
Novel spectral bands provide improved characterization of pediatric SAHS. These findings may pioneer a better understanding of the effects of SAHS on cardiac function and potentially serve as detection biomarkers.
Impact:
New specific heart rate variability (HRV) spectral bands are identified and characterized as potential biomarkers in pediatric sleep apnea. Spectral band BW1 (0.001-0.005 Hz) is related to macro sleep disruptions. Spectral band BW2 (0.028-0.074 Hz) is related to the duration of apneic events. An adaptive spectral band within the respiratory range, termed ABW3, is related to oxygen desaturations. The individual and collective diagnostic ability of these novel spectral bands outperforms classic HRV bands.
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