RT info:eu-repo/semantics/article
T1 Pediatric sleep apnea: Characterization of apneic events and sleep stages using heart rate variability
A1 Martín Montero, Adrián
A1 Armañac Julián, Pablo
A1 Gil, Eduardo
A1 Kheirandish Gozal, Leila
A1 Álvarez, Daniel
A1 Lázaro, Jesús
A1 Bailón, Raquel
A1 Gozal, David
A1 Laguna, Pablo
A1 Hornero Sánchez, Roberto
A1 Gutiérrez Tobal, Gonzalo César
K1 Obstructive sleep apnea
K1 Children
K1 Heart rate variability
K1 Apneic events
K1 Sleep stages
K1 Childhood adenotonsillectomy trial
K1 32 Ciencias Médicas
AB 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.
PB Elsevier
SN 0010-4825
YR 2023
FD 2023
LK https://uvadoc.uva.es/handle/10324/58346
UL https://uvadoc.uva.es/handle/10324/58346
LA eng
NO Computers in Biology and Medicine, 2023, vol. 154, 106549
NO Producción Científica
DS UVaDOC
RD 23-nov-2024