Pupillometric findings in children with obstructive sleep apnea
| Autor: | David Gozal, Mona F. Philby, Hari P.R. Bandla, Secil Aydinoz, Rakesh Bhattacharjee, Leila Kheirandish-Gozal, Selim Kilic |
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| Rok vydání: | 2015 |
| Předmět: |
Male
Sympathetic nervous system Polysomnography Autonomic Nervous System Reflex Pupillary Severity of Illness Index Article stomatognathic system Severity of illness medicine Humans Child Sleep Apnea Obstructive medicine.diagnostic_test business.industry Sleep apnea General Medicine medicine.disease nervous system diseases respiratory tract diseases Obstructive sleep apnea Autonomic nervous system medicine.anatomical_structure Blood pressure Child Preschool Anesthesia Female business Pupillometry |
| Zdroj: | Sleep Medicine. 16:1187-1191 |
| ISSN: | 1389-9457 |
| Popis: | Background Obstructive sleep apnea (OSA) leads to intermittent hypoxia, activation of the sympathetic nervous system, and eventually cardiovascular morbidity. Alterations in autonomic nervous system (ANS) tone and reflexes are likely to play major roles in OSA-associated morbidities, and have been identified in a subset of children with OSA. Objectives To evaluate whether pupillometry, a noninvasive and rapid bedside test for the assessment of autonomic nervous system dysfunction (ANS), would detect abnormal ANS function in children with OSA. Methods Children ages 2–12 years underwent polysomnography (PSG), and were divided based on PSG findings into two groups; Habitual Snorers (HS; AHI n = 17) and OSA (AHI > 1 h/TST, n = 49), the latter then sub-divided into AHI severity categories (>1 but 5 but 10 h/TST). Pupillometric measurements were performed during the clinic visit in a dark room using an automated pupillometer device. Results A total of 66 subjects with a mean age of 7.3 ± 2.6 years were recruited. There were no statistically significant differences between any of the groups, even when comparing severe OSA ( n = 15) and HS in any of the measures related to pupillary reflexes. However, mild, yet significant increases in systolic blood pressure and morning plasma norepinephrine levels were detected in the severe OSA group. Conclusion Although ANS perturbations are clearly present in a proportion of children with OSA, particularly those with severe disease, pupillary responses do not appear to provide a sensitive method for the detection of ANS dysfunction in OSA children. |
| Databáze: | OpenAIRE |
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