Poincaré Plot Width, Morning Urine Norepinephrine Levels, and Autonomic Imbalance in Children With Obstructive Sleep Apnea

Abstract Background Obstructive sleep apnea (OSA) in childhood is accompanied by sympathetic overflow unopposed by the parasympathetic tone. Complex methods like power spectral analysis of heart rate variability have been applied to study this imbalance. In this report, width of Poincaré scattergram...

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Bibliographic Details
Published in:Pediatric neurology 2014-08, Vol.51 (2), p.246-251
Main Authors: Chaidas, Konstantinos, MD, Tsaoussoglou, Marina, MSc, PhD, Theodorou, Emmanouel, MD, Lianou, Loukia, MD, Chrousos, George, MD, Kaditis, Athanasios G., MD
Format: Article
Language:English
Subjects:
Autonomic Nervous System Diseases - etiology
Autonomic Nervous System Diseases - physiopathology
Autonomic Nervous System Diseases - urine
Child
Child, Preschool
Electrocardiography
Heart Rate - physiology
Humans
Hypoxia - complications
Neurology
Norepinephrine - urine
Pediatrics
Poincaré plot
Polysomnography
sleep apnea
Sleep Apnea, Obstructive - complications
sleep-disordered breathing
sympathetic tone
urine norepinephrine
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Summary:Abstract Background Obstructive sleep apnea (OSA) in childhood is accompanied by sympathetic overflow unopposed by the parasympathetic tone. Complex methods like power spectral analysis of heart rate variability have been applied to study this imbalance. In this report, width of Poincaré scattergram of the R-R interval (parasympathetic tone) and morning urine norepinephrine concentration (sympathetic activity) were used to assess autonomic imbalance. Methods Poincaré plot was obtained from the electrocardiographic channel of nocturnal polysomnography and its width was measured, and norepinephrine-to-creatinine concentration ratio was calculated in morning urine specimen. Results Twenty children with obstructive sleep apnea and moderate-to-severe nocturnal hypoxemia (oxygen saturation of hemoglobin [SpO2 ] nadir
ISSN:0887-8994
1873-5150
DOI:10.1016/j.pediatrneurol.2014.05.003