Effect of respiration on heartbeat-evoked potentials during sleep in children with sleep-disordered breathing.
OBJECTIVE
Heartbeat-evoked potentials (HEPs) in electroencephalogram (EEG) provide a quantitative measure of cardiac interoception during sleep. We previously reported reduced HEPs in children with sleep-disordered breathing (SDB), indicative of attenuated cardiac information processing. The objective of this study was to investigate the link between HEP and respiration.


METHODS
From the overnight polysomnograms of 40 healthy children and 40 children with SDB, we measured HEPs during epochs of stage 2, slow-wave and rapid eye movement (REM) sleep free of abnormal respiratory events. HEPs were analysed with respect to respiratory phase.


RESULTS
We observed a marked association between respiratory phase and HEP in children with SDB during REM sleep, but not in normal children. In children with SDB, HEP waveforms were attenuated during expiration compared to inspiration. Following adenotonsillectomy, expiratory HEP peak amplitude increased in the SDB children and was no longer different from those of normal children.


CONCLUSIONS
The expiratory phase of respiration is primarily associated with attenuated cardiac information processing in children with SDB, establishing a pathophysiological link between breathing and HEP attenuation.
School of Electrical and Electronic Engineering, University of Adelaide, Adelaide, Australia. Electronic address: mathias.baumert@adelaide.edu.au.
Mathias
M
Baumert
Department of Respiratory and Sleep Medicine, Women's and Children's Hospital, Adelaide, Australia.
Yvonne
Y
Pamula
School of Psychology, Social Work and Social Policy, University of South Australia, Adelaide, Australia; Childrens Research Centre, School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, Australia.
Mark
M
Kohler
Department of Respiratory and Sleep Medicine, Women's and Children's Hospital, Adelaide, Australia.
James
J
Martin
Department of Respiratory and Sleep Medicine, Women's and Children's Hospital, Adelaide, Australia; Childrens Research Centre, School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, Australia.
Declan
D
Kennedy
School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, Australia.
Eugene
E
Nalivaiko
School of Electrical and Electronic Engineering, University of Adelaide, Adelaide, Australia.
Sarah A
SA
Immanuel
D016022:Case-Control Studies; D002648:Child; D005071:Evoked Potentials / Q000502:physiology*; D006801:Humans; D009200:Myocardial Contraction / Q000502:physiology*; D017286:Polysomnography; D012119:Respiration; D012143:Respiratory Physiological Phenomena; D012891:Sleep Apnea Syndromes / Q000503:physiopathology*; D012894:Sleep Stages / Q000502:physiology
Children; Heartbeat-evoked potentials; Respiration; Sleep-disordered breathing