Lisa M Walter1,2, Sarah N Biggs3,4, Lauren C Nisbet3, Aidan J Weichard3, Samantha L Hollis3, Margot J Davey3,4,5, Vicki Anderson6, Gillian M Nixon3,4,5, Rosemary S C Horne3,4. 1. The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Australia. lisa.walter@monash.edu. 2. Department of Paediatrics, Monash University, Melbourne, Australia. lisa.walter@monash.edu. 3. The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Australia. 4. Department of Paediatrics, Monash University, Melbourne, Australia. 5. Melbourne Children's Sleep Centre, Monash Children's Hospital, Melbourne, Australia. 6. Clinical Sciences Research, Murdoch Children's Research Institute, Melbourne, Australia.
Abstract
PURPOSE: Sleep-disordered breathing (SDB) prevalence peaks in preschool children and is associated with deficits in cardiovascular functioning during sleep. No long-term studies have investigated the effects of SDB resolution in mitigating these outcomes. We hypothesized that following 3 years, normalization of alterations to heart rate (HR), pulse transit time (PTT), heart rate variability (HRV), and urinary catecholamines identified at the initial diagnosis would be associated with resolution of SDB. METHODS: Forty-five children with SDB and 28 non-snoring controls underwent polysomnography at baseline (3-5 years) and follow-up (6-9 years). Children were classified into control, resolved, and unresolved SDB. Resolution was defined as an obstructive apnea-hypopnea index (OAHI) ≤1 event/h, no snoring on polysomnography (PSG), or indicated by parents. PTT is an inverse surrogate measure of blood pressure change. HRV was assessed using power spectral analysis. RESULTS: There was no change in PTT or HR between studies for any group. Our HRV data suggest reduced parasympathetic activity in children whose SDB resolved and increased parasympathetic activity in children whose SDB remained the same or worsened at follow-up. We identified a significant correlation between low frequency power and urinary dopamine and adrenaline levels at follow-up in the unresolved group, suggesting increased sympathetic activity in children with unresolved SDB. CONCLUSION: Our findings suggest an association between resolution of SDB and normalization of HRV in the long term in these preschool children and an augmented sympathetic activity in the children with residual SDB. This highlights the autonomic impact of SDB in young children and the importance of detection and treatment.
PURPOSE:Sleep-disordered breathing (SDB) prevalence peaks in preschool children and is associated with deficits in cardiovascular functioning during sleep. No long-term studies have investigated the effects of SDB resolution in mitigating these outcomes. We hypothesized that following 3 years, normalization of alterations to heart rate (HR), pulse transit time (PTT), heart rate variability (HRV), and urinary catecholamines identified at the initial diagnosis would be associated with resolution of SDB. METHODS: Forty-five children with SDB and 28 non-snoring controls underwent polysomnography at baseline (3-5 years) and follow-up (6-9 years). Children were classified into control, resolved, and unresolved SDB. Resolution was defined as an obstructive apnea-hypopnea index (OAHI) ≤1 event/h, no snoring on polysomnography (PSG), or indicated by parents. PTT is an inverse surrogate measure of blood pressure change. HRV was assessed using power spectral analysis. RESULTS: There was no change in PTT or HR between studies for any group. Our HRV data suggest reduced parasympathetic activity in children whose SDB resolved and increased parasympathetic activity in children whose SDB remained the same or worsened at follow-up. We identified a significant correlation between low frequency power and urinary dopamine and adrenaline levels at follow-up in the unresolved group, suggesting increased sympathetic activity in children with unresolved SDB. CONCLUSION: Our findings suggest an association between resolution of SDB and normalization of HRV in the long term in these preschool children and an augmented sympathetic activity in the children with residual SDB. This highlights the autonomic impact of SDB in young children and the importance of detection and treatment.
Authors: Sarah N Biggs; Lisa M Walter; Lauren C Nisbet; Angela R Jackman; Vicki Anderson; Gillian M Nixon; Margot J Davey; John Trinder; Robert Hoffmann; Roseanne Armitage; Rosemary S C Horne Journal: Sleep Med Date: 2012-07-02 Impact factor: 3.492
Authors: Duanping Liao; Xian Li; Sol M Rodriguez-Colon; Jiahao Liu; Alexandros N Vgontzas; Susan Calhoun; Edward O Bixler Journal: Sleep Med Date: 2010-04-01 Impact factor: 3.492
Authors: Lauren C Nisbet; Stephanie R Yiallourou; Sarah N Biggs; Gillian M Nixon; Margot J Davey; John A Trinder; Lisa M Walter; Rosemary S C Horne Journal: Sleep Date: 2013-08-01 Impact factor: 5.849
Authors: Keith McConnell; Virend K Somers; Thomas Kimball; Stephen Daniels; Rhonda VanDyke; Matthew Fenchel; Aliza Cohen; Paul Willging; Abu Shamsuzzaman; Raouf Amin Journal: Am J Respir Crit Care Med Date: 2009-03-12 Impact factor: 21.405
Authors: Carole L Marcus; Lee Jay Brooks; Kari A Draper; David Gozal; Ann Carol Halbower; Jacqueline Jones; Michael S Schechter; Sally Davidson Ward; Stephen Howard Sheldon; Richard N Shiffman; Christopher Lehmann; Karen Spruyt Journal: Pediatrics Date: 2012-08-27 Impact factor: 7.124
Authors: Anna Vlahandonis; Stephanie R Yiallourou; Scott A Sands; Gillian M Nixon; Margot J Davey; Lisa M Walter; Rosemary S C Horne Journal: Sleep Med Date: 2013-10-14 Impact factor: 3.492