What question did this study set out to answer?

Determine whether chaotic dynamics of heart rate variability can provide a noninvasive, sensitive marker of REM-induced sympathoexcitation and pediatric obstructive sleep apnea syndrome.

October 31, 2018Open Access

Non-High Frequency Heart Rate Chaos: A Noninvasive Marker of REM Sleep and Obstructive Sleep Apnea Syndrome in Children

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Why the study?

Does non-high frequency heart rate chaos assessment improve the noninvasive detection of mild and moderate/severe obstructive sleep apnea syndrome in children compared to conventional HRV metrics?

Key Points

Determine whether chaotic dynamics of heart rate variability can provide a noninvasive, sensitive marker of REM-induced sympathoexcitation and pediatric obstructive sleep apnea syndrome.
Evaluated 52 pediatric participants comprising 16 children with moderate-to-severe OSAS, 18 with mild OSAS, and 18 normal non-snoring controls.
Quantified heart rate variability chaos across REM and non-REM sleep stages using a sensitive noise titration assay, comparing results against conventional frequency-domain metrics and sample entropy.
Heart rate chaos increased significantly during REM compared to non-REM sleep, particularly in children with OSAS, correlating with sympathetic activation despite decreased high-frequency parasympathetic power.
Receiver operating characteristic analysis demonstrated that non-high frequency chaos detected even mild OSAS with diagnostic sensitivity and specificity superior to standard LF/HF ratios and sample entropy.

Structured PICO

Does non-high frequency heart rate chaos assessment improve the noninvasive detection of mild and moderate/severe obstructive sleep apnea syndrome in children compared to conventional HRV metrics?

Population

52 pediatric patients (age 1-16 years), including 16 with moderate/severe obstructive sleep apnea syndrome (OSAS), 18 with mild OSAS, and 18 normal non-snoring controls. All subjects were free of lung or neuromuscular disease, cardiac pathology, or arrhythmia.

Intervention

Assessment of non-high frequency heart rate chaos using a noise titration assay of heart rate variability (HRV) derived from continuous overnight ECG recordings.

Comparator

Conventional heart rate variability (HRV) metrics, including low- to high-frequency power ratio (LF/HF) and sample entropy, as well as comparison against normal non-snoring controls.

Outcome

Detection and discrimination of mild and moderate/severe OSAS using the noise limit (NL) metric compared to conventional HRV metrics.surrogate

Non-high frequency heart rate chaos provides a sensitive, noninvasive marker capable of detecting even mild obstructive sleep apnea syndrome in children, outperforming conventional heart rate variability metrics.

Limitations

Wide pediatric age range (1-16 years) with control subjects being slightly older (by ~3.3 years on average) than OSAS patients

Discussion

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Implication

May support REM sympathoexcitation markers for pediatric OSAS screening; leaves open need for prospective validation before clinical use.

Cite This Study

Deng et al. (2018) studied this question.

synapsesocial.com/papers/6a725561439bab0cabc3d258 https://doi.org/10.1101/457630

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Non-High Frequency Heart Rate Chaos: A Noninvasive Marker of REM Sleep and Obstructive Sleep Apnea Syndrome in Children

Key Points

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Non-High Frequency Heart Rate Chaos: A Noninvasive Marker of REM Sleep and Obstructive Sleep Apnea Syndrome in Children

Key Points

Structured PICO

Limitations

Discussion

Implication

Cite This Study

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