Association of sleep disorders with heart rate variability in children and adolescents with cystic fibrosis.

Rodrigo Dos Santos Lugao,Roberta Ribeiro Batista Barbosa,Márcio Vinícius Fagundes Donadio,Fernanda Mayrink Gonçalves Liberato,Roberta Barcellos Couto Olimpio De Carvalho,Roberta De Cássia Nunes Cruz Melotti,Pitiguara De Freitas Coelho,Pâmela Reis Vidal

doi:10.1590/1984-0462/2022/40/2020295

Abstract

ABSTRACTObjective:To assess the association of sleep disorders with the findings of heart rate variability (HRV) in children and adolescents with cystic fibrosis (CF).Methods:Cross-sectional study including children and adolescents aged six to 18 years with a clinical diagnosis of CF. Sociodemographic and clinical data were collected. Sleep disorders were evaluated using baseline nocturnal polysomnography. The autonomic nervous system (ANS) was evaluated through resting HRV.Results:A total of 30 individuals (11.2 years) with a mean forced expiratory volume in the first second (FEV1) of 62.7% were included. The respiratory disturbance index presented a median of 2.6 and obstructive sleep apnea syndrome (OSAS) was identified in 30%. In the HRV analysis, a mean standard deviation of all inter-beat (RR) intervals (SDNN) of 60.8±45.9ms was found. There was a significant correlation between the HRV low-frequency/high-frequency (LF/HF) global modulation index and the minimum SpO2 during sleep in patients with FEV1<60% (r=0.71; p=0.02). The prevalence of sleep disorders and HRV abnormalities was higher in individuals with lesser pulmonary function (FEV1<60%).Conclusions:The results indicate a weak correlation of sleep disorders (minimum SpO2) with HRV parameters (LH/HF) in children and adolescents with CF. When pulmonary function was reduced, a stronger correlation was found, highlighting the influence of disease severity. A high prevalence of ANS disorders, nocturnal hypoxemia, and presence of OSAS was also found.

Highlights

Cystic fibrosis (CF) is an inherited autosomal recessive disease that compromises and limits the function of almost every organ and system in the human body
Ramos et al.[6] demonstrated that 6% of 67 clinically stable children with CF presented hypoxemia during their sleep, whereas 26.9% of the children studied had significant desaturation (SpO2
A cross-sectional study was carried out evaluating individuals diagnosed with CF confirmed by genetic testing, aged between six and 18 years

Summary

INTRODUCTION

Cystic fibrosis (CF) is an inherited autosomal recessive disease that compromises and limits the function of almost every organ and system in the human body. Individuals with CF often present sleep disorders, including hypoxemia and obstructive sleep apnea syndrome (OSAS).[1,2] Episodes of nocturnal hypoxemia have been related to worsening pulmonary function and, increased mortality.[3,4] In addition, the decrease in the peripheral oxyhemoglobin saturation (SpO2) during the night has been associated with pulmonary hypertension, reduced sleep efficiency, and neurocognitive dysfunction during exacerbations.[5] Ramos et al.[6] demonstrated that 6% of 67 clinically stable children with CF presented hypoxemia during their sleep, whereas 26.9% of the children studied had significant desaturation (SpO2

METHOD

RESULTS

DISCUSSION

Conflict of interests