title: Central apnoeas have significant effects on blood pressure and heart rate in children.
abstract: Brief central apnoeas (CAs) during sleep are common in children and are not usually considered clinically significant unless associated with oxygen desaturation. CAs can occur spontaneously or following a movement or sigh. The aim of this study was to investigate acute cardiovascular changes associated with CAs in children. Beat-by-beat mean arterial pressure (MAP) and heart rate (HR) were analysed across CAs, and spontaneous and movement-induced events were compared using two-way analysis of variance with post hoc analyses. Fifty-three children (28 male/25 female) aged 7-12 years referred for investigation of sleep-disordered breathing (SDB) and 21 age-matched healthy controls (8 male/13 female) were studied. Children underwent routine clinical polysomnography with continuous blood pressure (BP) recordings. Movement-induced, but not spontaneous, CAs were more frequent in children with mild or moderate/severe obstructive sleep apnoea (OSA) compared with healthy controls (P < 0.05 for both). Movement-induced CAs were associated with significantly larger MAP and HR changes across the event compared with spontaneous CAs. The percentage changes in MAP and HR between late-event and post-event were significantly greater for movement-induced compared with spontaneous CAs (MAP 20.6 +/- 2.3 versus 12.2 +/- 1.8%, P < 0.01; HR 28.2 +/- 2.6 versus 14.7 +/- 2.5%, P < 0.001). This study demonstrates that movement-induced CAs are more common in children with OSA, and are associated with significantly greater changes in HR and BP compared with spontaneous CAs. These data suggest that movement-induced CAs should be considered when assessing the cardiovascular impact of SDB.
authors.affiliation: Ritchie Centre for Baby Health Research, Monash Institute of Medical Research, Monash University, Melbourne, Australia. denise.odriscoll@med.monash.edu.au
authors.forename: Denise M
authors.initials: DM
authors.lastname: O'Driscoll
authors.forename: Alison M
authors.initials: AM
authors.lastname: Foster
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Ng
authors.forename: Joel S C
authors.initials: JS
authors.lastname: Yang
authors.forename: Farhat
authors.initials: F
authors.lastname: Bashir
authors.forename: Shi
authors.initials: S
authors.lastname: Wong
authors.forename: Gillian M
authors.initials: GM
authors.lastname: Nixon
authors.forename: Margot J
authors.initials: MJ
authors.lastname: Davey
authors.forename: Vicki
authors.initials: V
authors.lastname: Anderson
authors.forename: Adrian M
authors.initials: AM
authors.lastname: Walker
authors.forename: John
authors.initials: J
authors.lastname: Trinder
authors.forename: Rosemary S C
authors.initials: RS
authors.lastname: Horne
mesh_terms: D001143:Arousal / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology*; D002648:Child; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D009043:Motor Activity / Q000502:physiology; D017286:Polysomnography; D012016:Reference Values; D020182:Sleep Apnea, Central / Q000175:diagnosis / Q000503:physiopathology*