Khositseth Anant, Chokechuleekorn Jittamas, Kuptanon Teeradej, Leejakpai Anchalee
Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Ann Pediatr Cardiol. 2013 Jan;6(1):39-42. doi: 10.4103/0974-2069.107232.
Obstructive sleep apnoea (OSA) can result in cardiovascular complications. Nocturnal arrhythmias are reported up to 50% of adult OSA patients. Arrhythmias and heart rate variability in children with OSA have not been well studied.
We sought to study rhythm disturbances in childhood OSA and also to analyze the relationship of heart rate variability to the severity of OSA in children.
In a retrospective cross sectional study, records of children aged < 15 years with history of snoring and suspected OSA, who had undergone polysomnography (PSG) for first time were analyzed. The cardiac rhythm and heart rate variability were studied during PSG.
A total of 124 patients diagnosed with OSA were grouped into mild (n = 52), moderate (n = 30), and severe (n = 42) OSA. During PSG, all had sinus arrhythmias and only three patients had premature atrial contractions (PACs). The standard deviation of heart rate (SD-HR) during rapid eye movement (REM) sleep in severe OSA (9.1 ± 2.4) was significantly higher than SD-HR in mild OSA (7.5 ± 1.3, P < 0.0001). The maximum heart rate (max-HR) during REM-sleep in severe OSA (132.1 ± 22.1) was significantly higher than the max-HR in mild OSA (121.3 ± 12.6 bpm, P = 0.016).
There was no significant arrhythmia in children with OSA during their sleep. Heart rate variability correlated with the severity of OSA.
阻塞性睡眠呼吸暂停(OSA)可导致心血管并发症。据报道,高达50%的成年OSA患者存在夜间心律失常。儿童OSA患者的心律失常和心率变异性尚未得到充分研究。
我们旨在研究儿童OSA的节律紊乱,并分析儿童心率变异性与OSA严重程度的关系。
在一项回顾性横断面研究中,分析了年龄<15岁、有打鼾病史且疑似OSA、首次接受多导睡眠图(PSG)检查的儿童的记录。在PSG期间研究心律和心率变异性。
总共124例被诊断为OSA的患者被分为轻度(n = 52)、中度(n = 30)和重度(n = 42)OSA。在PSG期间,所有患者均有窦性心律失常,只有3例患者有房性早搏(PACs)。重度OSA患者在快速眼动(REM)睡眠期间的心率标准差(SD-HR)(9.1±2.4)显著高于轻度OSA患者(7.5±1.3,P<0.0001)。重度OSA患者在REM睡眠期间的最大心率(max-HR)(132.1±22.1)显著高于轻度OSA患者(121.3±12.6次/分钟,P = 0.016)。
OSA儿童睡眠期间无明显心律失常。心率变异性与OSA的严重程度相关。