Pediatric sleep apnea: characterization of apneic events and sleep stages using heart rate variability

Martín-Montero, A. ; Armañac-Julián, P. (Universidad de Zaragoza) ; Gil, E. (Universidad de Zaragoza) ; Kheirandish-Gozal, L. ; Álvarez, D. ; Lázaro, J. (Universidad de Zaragoza) ; Bailón, R. (Universidad de Zaragoza) ; Gozal, D. ; Laguna, P. (Universidad de Zaragoza) ; Hornero, R. ; Gutiérrez-Tobal, G. C.

Resumen: Heart rate variability (HRV) is modulated by sleep stages and apneic events. Previous studies in children compared classical HRV parameters during sleep stages between obstructive sleep apnea (OSA) and controls. However, HRV-based characterization incorporating both sleep stages and apneic events has not been conducted. Furthermore, recently proposed novel HRV OSA-specific parameters have not been evaluated. Therefore, the aim of this study was to characterize and compare classic and pediatric OSA-specific HRV parameters while including both sleep stages and apneic events. A total of 1610 electrocardiograms from the Childhood Adenotonsillectomy Trial (CHAT) database were split into 10-min segments to extract HRV parameters. Segments were characterized and grouped by sleep stage (wake, W; non-rapid eye movement, NREMS; and REMS) and presence of apneic events (under 1 apneic event per segment, e/s; 1–5 e/s; 5–10 e/s; and over 10 e/s). NREMS showed significant changes in HRV parameters as apneic event frequency increased, which were less marked in REMS. In both NREMS and REMS, power in BW2, a pediatric OSA-specific frequency domain, allowed for the optimal differentiation among segments. Moreover, in the absence of apneic events, another defined band, BWRes, resulted in best differentiation between sleep stages. The clinical usefulness of segment-based HRV characterization was then confirmed by two ensemble-learning models aimed at estimating apnea-hypopnea index and classifying sleep stages, respectively. We surmise that basal sympathetic activity during REMS may mask apneic events-induced sympathetic excitation, thus highlighting the importance of incorporating sleep stages as well as apneic events when evaluating HRV in pediatric OSA.

Idioma: Inglés

DOI: 10.1016/j.compbiomed.2023.106549

Año: 2023

Publicado en: Computers in biology and medicine 154 (2023), 106549 [14 pp.]
ISSN: 0010-4825

Factor impacto JCR: 7.0 (2023)

Categ. JCR: BIOLOGY rank: 7 / 109 = 0.064 (2023) - Q1 - T1
Categ. JCR: MATHEMATICAL & COMPUTATIONAL BIOLOGY rank: 2 / 66 = 0.03 (2023) - Q1 - T1
Categ. JCR: ENGINEERING, BIOMEDICAL rank: 16 / 123 = 0.13 (2023) - Q1 - T1
Categ. JCR: COMPUTER SCIENCE, INTERDISCIPLINARY APPLICATIONS rank: 19 / 170 = 0.112 (2023) - Q1 - T1

Factor impacto CITESCORE: 11.7 - Health Informatics (Q1) - Computer Science Applications (Q1)

Factor impacto SCIMAGO: 1.481 - Health Informatics (Q1) - Computer Science Applications (Q1)

Financiación: info:eu-repo/grantAgreement/ES/DGA-FSE/T39-20R
Financiación: info:eu-repo/grantAgreement/ES/ISCIII-FEDER/CB19-01-00012
Financiación: info:eu-repo/grantAgreement/ES/MCIU-AEI-FEDER/PID2021-126734OB-C21
Financiación: info:eu-repo/grantAgreement/ES/MCIU/PRE2018-085219
Financiación: info:eu-repo/grantAgreement/ES/MICINN/RYC2019-028566-I
Financiación: info:eu-repo/grantAgreement/ES/MICIU-FEDER/PDC2021-120775-I00
Financiación: info:eu-repo/grantAgreement/ES/MICIU-FEDER/PID2019-104881RB-I00
Financiación: info:eu-repo/grantAgreement/ES/MICIU-FEDER/PID2020-115468RB-I00

Tipo y forma: Artículo (Versión definitiva)

Área (Departamento): Área Ingen.Sistemas y Automát. (Dpto. Informát.Ingenie.Sistms.)
Área (Departamento): Área Teoría Señal y Comunicac. (Dpto. Ingeniería Electrón.Com.)