ECG-derived Cardiopulmonary Analysis of Pediatric Sleep-Disordered Breathing

Authors:
Guo D, Peng CK, Wu H, L,Mietus JE, Liu Y, Sun RS, Thomas RJ

Reference:
Sleep Medicine 2011;12(4): 384-389

Objectives:
An ECG-derived sleep spectrogram, based on CPC analysis previously described in adults, can provide information about the severity of sleep disordered breathing (SDB) and coupled interactions of sleep modulated autonomic drive and respiration. We hypothesized that CPC algorithm-derived metrics will correlate with nasal pressure-based apnea–hypopnea scoring in pediatric population.

Conclusions:
ECG-derived sleep spectrogram metrics are correlated with nasal flow-derived respiratory abnormality in pediatric SDB. In suitable clinical contexts, this method may have screening utility and possibly allow tracking of treatment effects, specifically in children with severe SDB

Practical Significance:
The high correlation between CPC metrics and nasal flow derived metrics in pediatric SDB patients demonstrates an opportunity to screen for SDB and track treatment effects.

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Measuring sleep quality after adenotonsillectomy in pediatric sleep apnea.

Authors:
Lee SH, Choi JH, Park IH, Lee SH, Kim TH, Lee HM, Park HK, Thomas RJ, Shin C, Yun CH.

Reference:
Laryngoscope. 2012 Sep;122(9):2115-21.

Objectives:
To demonstrate postoperative changes in sleep quality in children with obstructive sleep apnea (OSA), using both conventional sleep staging and electrocardiogram-based cardiopulmonary coupling (CPC) analysis. The hypothesis is that being electroencephalography (EEG)-independent, CPC may detect changes in sleep quality that traditional sleep architecture analysis cannot.

Conclusions:
Adenotonsillectomy led to a significant change in CPC parameters (HFC, LFC), which was paralleled by significant improvements in the apnea-hypopnea and arousal index. Polysomnographic sleep stage parameters other than the arousal index did not reflect postoperative resolution of OSA.

Practical Significance:
In pediatric OSA, postoperative improvement of sleep quality is more readily discernible by CPC analysis than EEG-based sleep staging. The CPC analysis may have potential advantages in the assessment of sleep quality in pediatric populations.

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