Autonomic imbalance during apneic episodes in pediatric obstructive sleep apnea

作者：Vitelli Ottavio; Del Pozzo Marco; Baccari Giorgio; Rabasco Jole; Pietropaoli Nicoletta; Barreto Mario; Villa Maria Pia^*

来源：Clinical Neurophysiology, 2016, 127(1): 551-555.

DOI：10.1016/j.clinph.2015.05.025

• Autonomic nervous system
• Obstructive sleep apnea
• Children
• Heart rate variability
• Pediatric
• Autonomic impairment

Objectives: To investigate the activity of the autonomic nervous system (ANS) during sleep in children with obstructive sleep apnea (OSA), in order to detect a possible cardiac ANS imbalance analyzing heart rate variability (HRV).
Methods: 43 subjects between 4 and 12 years of age (7.26 +/- 2.8 years), undergoing a diagnostic assessment for OSA were evaluated. A time domain index (R-apnea index) was developed to evaluate HRV strictly related to obstructive events during sleep. Poincare plot of RR intervals during the whole night was calculated.
Results: R-apnea index was negatively correlated with apnea hypopnea index (AHI) (r = -0.360, p = 0.028). AHI and the duration of the disease were the only variables that were significantly correlated with R-apnea index. Three groups were subsequently created according to polysomnographic findings considering AHI. R-apnea index resulted significantly lower in patient with severe OSA compared to primary snoring/mild OSA subjects (p < 0.05). Looking at Poincare plot, SD1 showed a diminishing trend with severity of OSA, however not reaching statistical significance.
Conclusions: Our findings suggest an autonomic impairment in OSA children evidenced by the altered HRV both in the very short term (R-apnea index) and in short term (SD1).
Significance: R-apnea index is an easy and cheap method to undelay early ANS imbalance.

• 出版日期2016-1