Title | Autonomic imbalance during apneic episodes in pediatric obstructive sleep apnea. | ||
Author | Vitelli, Ottavio; Del Pozzo, Marco; Baccari, Giorgio; Rabasco, Jole; Pietropaoli, Nicoletta; Barreto, Mario; Villa, Maria Pia | ||
Journal | Clin Neurophysiol | Publication Year/Month | 2016-Jan |
PMID | 26100148 | PMCID | -N/A- |
Affiliation + expend | 1.Neuroscience, Mental Health and Sense Organs Department, Sleep Disorder Centre, Faculty of Medicine and Psychology, "La Sapienza" University, Rome, Italy. |
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.