Phenotype of ventilatory control in children with moderate to severe persistent asthma and obstructive sleep apnea
| Autor: | Zhihui He, Raouf S. Amin, Keren Armoni Domany, Yuanfang Xu, Keith McConnell, Monir Hossain, Michael C. K. Khoo, Leonardo Nava-Guerra, Mark DiFrancesco |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
Spirometry medicine.medical_specialty Vital capacity Adolescent Polysomnography Population Sleep Slow-Wave Pulmonary function testing Forced Expiratory Volume Physiology (medical) Internal medicine Tidal Volume Humans Medicine Child education Lung Asthma Sleep Apnea Obstructive education.field_of_study medicine.diagnostic_test business.industry Snoring Bayes Theorem medicine.disease Respiratory Function Tests respiratory tract diseases Obstructive sleep apnea Phenotype Gas homeostasis Child Preschool Cardiology Female Neurology (clinical) Blood Gas Analysis business |
| Zdroj: | Sleep. 42 |
| ISSN: | 1550-9109 0161-8105 |
| DOI: | 10.1093/sleep/zsz130 |
| Popis: | Study ObjectivesTo examine the role of ventilatory control in asthmatic children with obstructive sleep apnea (OSA) and the relationships between measures of ventilatory control, OSA severity, and pulmonary function.MethodsFive- to 18-year-old children with persistent asthma and nightly snoring were enrolled in the study. Children had physical examination, pulmonary function test, and polysomnography. Loop and controller gains were derived from 5 min segments which included a sigh during nonrapid eye movement sleep by applying a mathematical model that quantifies ventilatory control from the ensuing responses to the sighs. Plant gain was derived from 5 min segments of spontaneous breathing (i.e. without sighs). Nonparametric statistical tests were used for group comparisons. Cluster analysis was performed using Bayesian profile regression.ResultsOne hundred thirty-four children were included in the study, 77 with and 57 without OSA. Plant gain was higher in children with OSA than in those without OSA (p = 0.002). A negative correlation was observed between plant gain and forced expiratory volume in 1 second (p = 0.048) and the ratio of f forced expiratory volume to forced vital capacity (p = 0.02). Plant gain correlated positively with severity of OSA. Cluster analysis demonstrated that children with more severe OSA and abnormal lung function had higher plant gain and a lower controller gain compared with the rest of the population.ConclusionsChildren with OSA and persistent asthma with abnormal lung function have phenotypic characteristics which consist of diminished capacity of the lungs to maintain blood gas homeostasis reflected by an increase in plant gain and decreased chemoreceptor sensitivity. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|