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    Por favor, use este identificador para citar o enlazar este ítem:https://uvadoc.uva.es/handle/10324/58346

    Título
    Pediatric sleep apnea: Characterization of apneic events and sleep stages using heart rate variability
    Autor
    Martín Montero, AdriánAutoridad UVA
    Armañac Julián, Pablo
    Gil, Eduardo
    Kheirandish Gozal, Leila
    Álvarez González, DanielAutoridad UVA Orcid
    Lázaro, Jesús
    Bailón, Raquel
    Gozal, David
    Laguna, Pablo
    Hornero Sánchez, RobertoAutoridad UVA Orcid
    Gutierrez Tobal, Gonzalo CésarAutoridad UVA Orcid
    Año del Documento
    2023
    Editorial
    Elsevier
    Descripción
    Producción Científica
    Documento Fuente
    Computers in Biology and Medicine, 2023, vol. 154, 106549
    Resumen
    Heart rate variability (HRV) is modulated by sleep stages and apneic events. Previous studies in children compared classical HRV parameters during sleep stages between obstructive sleep apnea (OSA) and controls. However, HRV-based characterization incorporating both sleep stages and apneic events has not been conducted. Furthermore, recently proposed novel HRV OSA-specific parameters have not been evaluated. Therefore, the aim of this study was to characterize and compare classic and pediatric OSA-specific HRV parameters while including both sleep stages and apneic events. A total of 1610 electrocardiograms from the Childhood Adenotonsillectomy Trial (CHAT) database were split into 10-minute segments to extract HRV parameters. Segments were characterized and grouped by sleep stage (wake, W; non-rapid eye movement, NREMS; and REMS) and presence of apneic events (under 1 apneic event per segment, e/s; 1–5 e/s; 5–10 e/s; and over 10 e/s). NREMS showed significant changes in HRV parameters as apneic event frequency increased, which were less marked in REMS. In both NREMS and REMS, power in BW2, a pediatric OSA-specific frequency domain, allowed for the optimal differentiation among segments. Moreover, in the absence of apneic events, another defined band, BWRes, resulted in best differentiation between sleep stages. The clinical usefulness of segment-based HRV characterization was then confirmed by two ensemble-learning models aimed at estimating apnea-hypopnea index and classifying sleep stages, respectively. We surmise that basal sympathetic activity during REMS may mask apneic events-induced sympathetic excitation, thus highlighting the importance of incorporating sleep stages as well as apneic events when evaluating HRV in pediatric OSA.
    Materias Unesco
    32 Ciencias Médicas
    Palabras Clave
    Obstructive sleep apnea
    Children
    Heart rate variability
    Apneic events
    Sleep stages
    Childhood adenotonsillectomy trial
    ISSN
    0010-4825
    Revisión por pares
    SI
    DOI
    10.1016/j.compbiomed.2023.106549
    Patrocinador
    Ministerio de Ciencia, Innovación y Universidades y el Fondo Europeo de Desarrollo Regional (FEDER) under projects (PID2019-104881RB-I00), (PID2020-115468RB-I00), (PDC2021-120775-I00) and (PID2021-126734OB-C21)
    Sociedad Española de Sueño (SES) en el marco del proyecto “Beca de Investigación SES 2019”, by 'CIBER-Consorcio Centro de Investigación Biomédica en Red- (CB19/01/00012)' a través del 'Instituto de Salud Carlos III' co- financiado con fondos FEDER, así como bajo el proyecto SleepyHeart de la convocatoria de valorización 2020, y por el Gobierno de Aragón (Grupo de Referencia BSICoS T39-20R).
    The National Sleep Research Resource was supported by the National Heart, Lung, and Blood Institute (R24 HL114473, 75N92019R002).
    Ministerio de Ciencia, Innovación y Universidades, “Ayudas para contratos predoctorales para la Formación de Doctores” grant (PRE2018-085219) and “Ramón y Cajal” (MICIU/FSE) grant (RYC2019-028566-I)
    Institutos Nacionales de Salud-"Ensayo de adenoamigdalectomía infantil (CHAT)"- (HL083075, HL083129, UL1-RR-024134, UL1 RR024989) and (grant AG061824).
    Version del Editor
    https://www.sciencedirect.com/science/article/pii/S0010482523000148
    Propietario de los Derechos
    © 2023 The Author(s)
    Idioma
    eng
    URI
    https://uvadoc.uva.es/handle/10324/58346
    Tipo de versión
    info:eu-repo/semantics/publishedVersion
    Derechos
    openAccess
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    • GIB - Artículos de revista [36]
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