Cardiac and sympathetic activation are reduced in children with Down syndrome and sleep disordered breathing

Denise Marie O'Driscoll, Rosemary Sylvia Claire Horne, Margot J Davey, Sarah Anne Hope, Vicki Anne Anderson, John A Trinder, Adrian Mark Walker, Gillian Michelle Nixon

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12 Citations (Scopus)

Abstract

Sleep disordered breathing (SDB) occurs at an increased incidence in children with Down Syndrome (DS) compared to the general pediatric population. We hypothesized that, compared with typically developing (TD) children with SDB, children with DS have a reduced cardiovascular response with delayed reoxygenation after obstructive respiratory events, and reduced sympathetic drive, providing a potential explanation for their increased risk of pulmonary hypertension. DESIGN: Beat-by-beat heart rate (HR) was analyzed over the course of obstructive events (pre, early, late, post-event) and compared between groups. Also compared were the time for oxygen resaturation post-event and overnight urinary catecholamines. SETTING: Pediatric sleep laboratory. PATIENTS: Sixty-four children aged 2-17 y referred for investigation of SDB (32 DS; 32 TD) matched for age and obstructive apnea/hypopnea index. MEASUREMENT AND RESULTS: Children underwent overnight polysomnography with overnight urine collection. Compared to TD children, those with DS had significantly reduced HR changes post-event during NREM (DS: 21.4 +/- 1.8 , TD: 26.6 +/- 1.6 , change from late to post-event, P <0.05). The time to resaturation post-event was significantly increased in the DS group (P <0.05 for both NREM and REM sleep). Children with DS had significantly reduced overnight urinary noradrenaline (P <0.01), adrenaline (P <0.05) and dopamine levels (P <0.01) compared with TD children. CONCLUSION: Children with DS and SDB exhibit a compromised acute cardio-respiratory response and dampened sympathetic response to SDB compared with TD children with SDB. These data may reflect autonomic dysfunction in children with DS that may place them at increased risk for cardiovascular complications such as pulmonary hypertension.
Original languageEnglish
Pages (from-to)1269 - 1275
Number of pages7
JournalSleep
Volume35
Issue number9
DOIs
Publication statusPublished - 2012

Cite this

@article{732f130619c84550b90669bc6ca42782,
title = "Cardiac and sympathetic activation are reduced in children with Down syndrome and sleep disordered breathing",
abstract = "Sleep disordered breathing (SDB) occurs at an increased incidence in children with Down Syndrome (DS) compared to the general pediatric population. We hypothesized that, compared with typically developing (TD) children with SDB, children with DS have a reduced cardiovascular response with delayed reoxygenation after obstructive respiratory events, and reduced sympathetic drive, providing a potential explanation for their increased risk of pulmonary hypertension. DESIGN: Beat-by-beat heart rate (HR) was analyzed over the course of obstructive events (pre, early, late, post-event) and compared between groups. Also compared were the time for oxygen resaturation post-event and overnight urinary catecholamines. SETTING: Pediatric sleep laboratory. PATIENTS: Sixty-four children aged 2-17 y referred for investigation of SDB (32 DS; 32 TD) matched for age and obstructive apnea/hypopnea index. MEASUREMENT AND RESULTS: Children underwent overnight polysomnography with overnight urine collection. Compared to TD children, those with DS had significantly reduced HR changes post-event during NREM (DS: 21.4 +/- 1.8 , TD: 26.6 +/- 1.6 , change from late to post-event, P <0.05). The time to resaturation post-event was significantly increased in the DS group (P <0.05 for both NREM and REM sleep). Children with DS had significantly reduced overnight urinary noradrenaline (P <0.01), adrenaline (P <0.05) and dopamine levels (P <0.01) compared with TD children. CONCLUSION: Children with DS and SDB exhibit a compromised acute cardio-respiratory response and dampened sympathetic response to SDB compared with TD children with SDB. These data may reflect autonomic dysfunction in children with DS that may place them at increased risk for cardiovascular complications such as pulmonary hypertension.",
author = "O'Driscoll, {Denise Marie} and Horne, {Rosemary Sylvia Claire} and Davey, {Margot J} and Hope, {Sarah Anne} and Anderson, {Vicki Anne} and Trinder, {John A} and Walker, {Adrian Mark} and Nixon, {Gillian Michelle}",
year = "2012",
doi = "10.5665/sleep.2084",
language = "English",
volume = "35",
pages = "1269 -- 1275",
journal = "Sleep",
issn = "0161-8105",
publisher = "Associated Professional Sleep Societies",
number = "9",

}

Cardiac and sympathetic activation are reduced in children with Down syndrome and sleep disordered breathing. / O'Driscoll, Denise Marie; Horne, Rosemary Sylvia Claire; Davey, Margot J; Hope, Sarah Anne; Anderson, Vicki Anne; Trinder, John A; Walker, Adrian Mark; Nixon, Gillian Michelle.

In: Sleep, Vol. 35, No. 9, 2012, p. 1269 - 1275.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Cardiac and sympathetic activation are reduced in children with Down syndrome and sleep disordered breathing

AU - O'Driscoll, Denise Marie

AU - Horne, Rosemary Sylvia Claire

AU - Davey, Margot J

AU - Hope, Sarah Anne

AU - Anderson, Vicki Anne

AU - Trinder, John A

AU - Walker, Adrian Mark

AU - Nixon, Gillian Michelle

PY - 2012

Y1 - 2012

N2 - Sleep disordered breathing (SDB) occurs at an increased incidence in children with Down Syndrome (DS) compared to the general pediatric population. We hypothesized that, compared with typically developing (TD) children with SDB, children with DS have a reduced cardiovascular response with delayed reoxygenation after obstructive respiratory events, and reduced sympathetic drive, providing a potential explanation for their increased risk of pulmonary hypertension. DESIGN: Beat-by-beat heart rate (HR) was analyzed over the course of obstructive events (pre, early, late, post-event) and compared between groups. Also compared were the time for oxygen resaturation post-event and overnight urinary catecholamines. SETTING: Pediatric sleep laboratory. PATIENTS: Sixty-four children aged 2-17 y referred for investigation of SDB (32 DS; 32 TD) matched for age and obstructive apnea/hypopnea index. MEASUREMENT AND RESULTS: Children underwent overnight polysomnography with overnight urine collection. Compared to TD children, those with DS had significantly reduced HR changes post-event during NREM (DS: 21.4 +/- 1.8 , TD: 26.6 +/- 1.6 , change from late to post-event, P <0.05). The time to resaturation post-event was significantly increased in the DS group (P <0.05 for both NREM and REM sleep). Children with DS had significantly reduced overnight urinary noradrenaline (P <0.01), adrenaline (P <0.05) and dopamine levels (P <0.01) compared with TD children. CONCLUSION: Children with DS and SDB exhibit a compromised acute cardio-respiratory response and dampened sympathetic response to SDB compared with TD children with SDB. These data may reflect autonomic dysfunction in children with DS that may place them at increased risk for cardiovascular complications such as pulmonary hypertension.

AB - Sleep disordered breathing (SDB) occurs at an increased incidence in children with Down Syndrome (DS) compared to the general pediatric population. We hypothesized that, compared with typically developing (TD) children with SDB, children with DS have a reduced cardiovascular response with delayed reoxygenation after obstructive respiratory events, and reduced sympathetic drive, providing a potential explanation for their increased risk of pulmonary hypertension. DESIGN: Beat-by-beat heart rate (HR) was analyzed over the course of obstructive events (pre, early, late, post-event) and compared between groups. Also compared were the time for oxygen resaturation post-event and overnight urinary catecholamines. SETTING: Pediatric sleep laboratory. PATIENTS: Sixty-four children aged 2-17 y referred for investigation of SDB (32 DS; 32 TD) matched for age and obstructive apnea/hypopnea index. MEASUREMENT AND RESULTS: Children underwent overnight polysomnography with overnight urine collection. Compared to TD children, those with DS had significantly reduced HR changes post-event during NREM (DS: 21.4 +/- 1.8 , TD: 26.6 +/- 1.6 , change from late to post-event, P <0.05). The time to resaturation post-event was significantly increased in the DS group (P <0.05 for both NREM and REM sleep). Children with DS had significantly reduced overnight urinary noradrenaline (P <0.01), adrenaline (P <0.05) and dopamine levels (P <0.01) compared with TD children. CONCLUSION: Children with DS and SDB exhibit a compromised acute cardio-respiratory response and dampened sympathetic response to SDB compared with TD children with SDB. These data may reflect autonomic dysfunction in children with DS that may place them at increased risk for cardiovascular complications such as pulmonary hypertension.

UR - http://www.journalsleep.org/ViewAbstract.aspx?pid=28640

U2 - 10.5665/sleep.2084

DO - 10.5665/sleep.2084

M3 - Article

VL - 35

SP - 1269

EP - 1275

JO - Sleep

JF - Sleep

SN - 0161-8105

IS - 9

ER -