Sleep disordered breathing and autonomic function in overweight and obese children and adolescents

Obstructive sleep apnoea (OSA), common in children with obesity, is associated with cardiovascular morbidity. Autonomic dysfunction has been suggested to be a key player in the development of these complications. We investigated the relationship between obesity, OSA and sympathetic activity in child...

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Main Authors: Annelies Van Eyck, Kim Van Hoorenbeeck, Benedicte Y. De Winter, Luc Van Gaal, Wilfried De Backer, Stijn L. Verhulst
Format: Article
Language:English
Published: European Respiratory Society 2016-12-01
Series:ERJ Open Research
Online Access:http://openres.ersjournals.com/content/2/4/00038-2016.full
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author Annelies Van Eyck
Kim Van Hoorenbeeck
Benedicte Y. De Winter
Luc Van Gaal
Wilfried De Backer
Stijn L. Verhulst
author_facet Annelies Van Eyck
Kim Van Hoorenbeeck
Benedicte Y. De Winter
Luc Van Gaal
Wilfried De Backer
Stijn L. Verhulst
author_sort Annelies Van Eyck
collection DOAJ
description Obstructive sleep apnoea (OSA), common in children with obesity, is associated with cardiovascular morbidity. Autonomic dysfunction has been suggested to be a key player in the development of these complications. We investigated the relationship between obesity, OSA and sympathetic activity in children. 191 children with obesity were included and distributed into two groups: 131 controls and 60 with OSA. Beat-to-beat RR interval data were extracted from polysomnography for heart rate variability analysis. Urinary free cortisol levels were determined. Urinary free cortisol did not differ between groups and was not associated with OSA, independent of the level of obesity. Differences in heart rate variability measures were found: mean RR interval decreased with OSA, while low/high-frequency band ratio and mean heart rate increased with OSA. Heart rate variability measures correlated with OSA, independent of obesity parameters and age: oxygen desaturation index correlated with mean heart rate (r=0.19, p=0.009) and mean RR interval (r= −0.18, p=0.02), while high-frequency bands and low/high-frequency band ratio correlated with arterial oxygen saturation measured by pulse oximetry (SpO2) (r= −0.20, p=0.008 and r= −0.16, p=0.04) and SpO2 nadir (r=0.23, p=0.003 and r= −0.19, p=0.02). These results suggest that sympathetic heart activity is increased in children with obesity and OSA. Measures of hypoxia were related to increased sympathetic tone, suggesting that intermittent hypoxia is involved in autonomic dysfunction.
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spelling doaj.art-455f6ec59d58449c84b0e090424144002022-12-21T18:43:50ZengEuropean Respiratory SocietyERJ Open Research2312-05412016-12-012410.1183/23120541.00038-201600038-2016Sleep disordered breathing and autonomic function in overweight and obese children and adolescentsAnnelies Van Eyck0Kim Van Hoorenbeeck1Benedicte Y. De Winter2Luc Van Gaal3Wilfried De Backer4Stijn L. Verhulst5 Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp, Belgium Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp, Belgium Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp, Belgium Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp, Belgium Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp, Belgium Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp, Belgium Obstructive sleep apnoea (OSA), common in children with obesity, is associated with cardiovascular morbidity. Autonomic dysfunction has been suggested to be a key player in the development of these complications. We investigated the relationship between obesity, OSA and sympathetic activity in children. 191 children with obesity were included and distributed into two groups: 131 controls and 60 with OSA. Beat-to-beat RR interval data were extracted from polysomnography for heart rate variability analysis. Urinary free cortisol levels were determined. Urinary free cortisol did not differ between groups and was not associated with OSA, independent of the level of obesity. Differences in heart rate variability measures were found: mean RR interval decreased with OSA, while low/high-frequency band ratio and mean heart rate increased with OSA. Heart rate variability measures correlated with OSA, independent of obesity parameters and age: oxygen desaturation index correlated with mean heart rate (r=0.19, p=0.009) and mean RR interval (r= −0.18, p=0.02), while high-frequency bands and low/high-frequency band ratio correlated with arterial oxygen saturation measured by pulse oximetry (SpO2) (r= −0.20, p=0.008 and r= −0.16, p=0.04) and SpO2 nadir (r=0.23, p=0.003 and r= −0.19, p=0.02). These results suggest that sympathetic heart activity is increased in children with obesity and OSA. Measures of hypoxia were related to increased sympathetic tone, suggesting that intermittent hypoxia is involved in autonomic dysfunction.http://openres.ersjournals.com/content/2/4/00038-2016.full
spellingShingle Annelies Van Eyck
Kim Van Hoorenbeeck
Benedicte Y. De Winter
Luc Van Gaal
Wilfried De Backer
Stijn L. Verhulst
Sleep disordered breathing and autonomic function in overweight and obese children and adolescents
ERJ Open Research
title Sleep disordered breathing and autonomic function in overweight and obese children and adolescents
title_full Sleep disordered breathing and autonomic function in overweight and obese children and adolescents
title_fullStr Sleep disordered breathing and autonomic function in overweight and obese children and adolescents
title_full_unstemmed Sleep disordered breathing and autonomic function in overweight and obese children and adolescents
title_short Sleep disordered breathing and autonomic function in overweight and obese children and adolescents
title_sort sleep disordered breathing and autonomic function in overweight and obese children and adolescents
url http://openres.ersjournals.com/content/2/4/00038-2016.full
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