Key result
Sleep-disordered breathing in children was associated with increased vasomotor activity and decreased baroreflex sensitivity during non-REM sleep, which reversed after adenotonsillectomy.
Why the study?
Does adenotonsillectomy improve nocturnal cardiovascular control in children with sleep-disordered breathing?
Observational (n=62)
Does adenotonsillectomy improve nocturnal cardiovascular control in children with sleep-disordered breathing?
Adenotonsillectomy reverses the altered nocturnal cardiovascular control, including increased vasomotor activity and decreased baroreflex sensitivity, observed in children with mild-to-moderate sleep-disordered breathing.
May support adenotonsillectomy to normalize nocturnal cardiovascular control in pediatric SDB; hypothesis-generating and requires randomized confirmation.
Study objectives: To assess cardiovascular control during sleep in children with sleep-disordered breathing (SDB) and the effect of adenotonsillectomy in comparison to healthy nonsnoring children. Methods: Cardiorespiratory signals obtained from overnight polysomnographic recordings of 28 children with SDB and 34 healthy nonsnoring children were analyzed. We employed an autoregressive closed-loop model with heart period (RR) and pulse transit time (PTT) as outputs and respiration as an external input to obtain estimates of respiratory gain and baroreflex gain. Results: Mean and variability of PTT were increased in children with SDB across all stages of sleep. Low frequency power of RR and PTT were attenuated during non-rapid eye movement (REM) sleep. Baroreflex sensitivity was reduced in children with SDB in stage 2 sleep, while respiratory gain was increased in slow wave sleep. After adenotonsillectomy, these indices normalized in the SDB group attaining values comparable to those of healthy children. Conclusions: In children with mild-to-moderate SDB, vasomotor activity is increased and baroreflex sensitivity decreased during quiet, event-free non-REM sleep. Adenotonsillectomy appears to reverse this effect.
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El-Hamad et al. (2017) conducted an observational in Sleep-disordered breathing (n=62). Sleep-disordered breathing vs. Healthy nonsnoring children was evaluated on Cardiovascular control during sleep (respiratory gain and baroreflex gain). Sleep-disordered breathing in children was associated with increased vasomotor activity and decreased baroreflex sensitivity during non-REM sleep, which reversed after adenotonsillectomy.
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