Format

Send to

Choose Destination
Sleep. 2005 Jun;28(6):747-52.

Autonomic dysfunction in children with sleep-disordered breathing.

Author information

1
Kosair Children's Hospital Research Institute, and Division of Pediatric Sleep Medicine, Department of Pediatrics, University of Louisville, Louisville, KY 40202, USA.

Abstract

STUDY OBJECTIVES:

To measure sympathetic responses in children with and without sleep-disordered breathing.

DESIGN:

Prospective, observational study.

SETTING:

Kosair Children's Hospital Sleep Medicine and Apnea Center.

PARTICIPANTS:

Subjects were prospectively recruited from children undergoing overnight polysomnographic assessments and were retrospectively grouped according to the results of the polysomnogram. Sleep-disordered breathing was defined as an apnea-hypopnea index >5 and children were assigned to the control group if their apnea-hypopnea index was < 1.

INTERVENTION:

N/A.

MEASUREMENTS AND RESULTS:

During quiet wakefulness, pulse arterial tonometry was used to assess changes in sympathetic activity following vital capacity sighs in 28 children with sleep-disordered breathing and 29 controls. Each child underwent a series of 3 sighs, and the average maximal pulse arterial tonometry signal attenuation was calculated. Further, a cold pressor test was conducted in a subset of 14 children with sleep-disordered breathing and 14 controls. The left hand was immersed in ice cold water for 30 seconds while right-hand pulse arterial tonometry signal was continuously monitored during immersion and 20-minute recovery periods. Signal amplitude changes were expressed as percentage change from corresponding baseline.

RESULTS:

The magnitude of sympathetic discharge-induced attenuation of pulse arterial tonometry signal was significantly increased in children with sleep-disordered breathing during sigh maneuvers (74.1% +/- 10.7% change compared with 59.2% +/- 13.2% change in controls; P<.0001) and the cold pressor test (83.5% +/- 7.3% change compared with 74.1% +/- 11.4% change in controls; P=.039). Further, recovery kinetics in control children were faster than those of children with sleep-disordered breathing.

CONCLUSION:

Children with sleep-disordered breathing have altered autonomic nervous system regulation as evidenced by increased sympathetic vascular reactivity during wakefulness.

PMID:
16477962
DOI:
10.1093/sleep/28.6.747
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Silverchair Information Systems
Loading ...
Support Center