Effect of respiration on heartbeat-evoked potentials during sleep in children with sleep-disordered breathing

Mathias Baumert; Yvonne Pamula; Mark Kohler; James Martin; Declan Kennedy; Eugene Nalivaiko; Sarah A Immanuel

doi:10.1016/j.sleep.2015.02.528

Effect of respiration on heartbeat-evoked potentials during sleep in children with sleep-disordered breathing

Sleep Med. 2015 May;16(5):665-7. doi: 10.1016/j.sleep.2015.02.528. Epub 2015 Mar 9.

Authors

Mathias Baumert¹, Yvonne Pamula², Mark Kohler³, James Martin², Declan Kennedy⁴, Eugene Nalivaiko⁵, Sarah A Immanuel⁶

Affiliations

¹ School of Electrical and Electronic Engineering, University of Adelaide, Adelaide, Australia. Electronic address: mathias.baumert@adelaide.edu.au.
² Department of Respiratory and Sleep Medicine, Women's and Children's Hospital, Adelaide, Australia.
³ 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.
⁴ 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.
⁵ School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, Australia.
⁶ School of Electrical and Electronic Engineering, University of Adelaide, Adelaide, Australia.

PMID: 25912598
DOI: 10.1016/j.sleep.2015.02.528

Abstract

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.

Patients/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.

Keywords: Children; Heartbeat-evoked potentials; Respiration; Sleep-disordered breathing.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Case-Control Studies
Child
Evoked Potentials / physiology*
Humans
Myocardial Contraction / physiology*
Polysomnography
Respiration*
Respiratory Physiological Phenomena
Sleep Apnea Syndromes / physiopathology*
Sleep Stages / physiology