Heart rate surge at respiratory event termination in preterm and term born children with sleep disordered breathing.

Autor: Walter LM; Department of Paediatrics, Monash University, Melbourne, Australia. Electronic address: lisa.walter@monash.edu., Ooi JY; Department of Paediatrics, Monash University, Melbourne, Australia., Kleeman EA; Department of Paediatrics, Monash University, Melbourne, Australia., Bassam A; Department of Paediatrics, Monash University, Melbourne, Australia., Nixon GM; Department of Paediatrics, Monash University, Melbourne, Australia; Melbourne Children's Sleep Centre, Monash Children's Hospital, Melbourne, Australia., Horne RS; Department of Paediatrics, Monash University, Melbourne, Australia.
Jazyk: angličtina
Zdroj: Sleep medicine [Sleep Med] 2023 Jan; Vol. 101, pp. 127-134. Date of Electronic Publication: 2022 Nov 02.
DOI: 10.1016/j.sleep.2022.10.022
Abstrakt: Background: Repetitive surges in heart rate (HR) at respiratory event termination underpin the altered autonomic HR control associated with sleep disordered breathing (SDB). As children born preterm are at greater risk of adverse cardiovascular outcomes, we aimed to determine whether the HR response to obstructive respiratory events was elevated compared to term-born children.
Methods: Fifty children (3-12 years) born preterm, were matched for SDB severity, age and gender with term born children. Multilevel modelling determined the effect of preterm birth and arousal on HR changes between a 10s baseline to the latter half of respiratory events and 15s post event during NREM and REM.
Results: 1203 events were analysed (NREM: term 380; preterm 383; REM: term 207; preterm 233). During NREM fewer events terminated in arousal in the preterm compared with term group (preterm 68%; term 84%; χ 2  = 27.2, p < 0.001). There were no differences in REM. During NREM, HR was lower in the preterm group at all event phases, with and without associated arousals (P < 0.01 for all). % change in HR from baseline to post event was higher in the preterm compared with term group (preterm: median 23% IQR (12%,34%); term: 18% (10%,29%); p < 0.01) and late event to post event (preterm: 30% (21%, 32%); term 28% (20%,39%); p < 0.01) in events associated with arousals.
Conclusion: The greater magnitude of surges in HR following respiratory events terminating with arousal in preterm born children, although small, occur repeatedly throughout the night and may contribute to adverse cardiovascular outcomes, although further studies are required.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2022 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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