Baroreflex sensitivity after adenotonsillectomy in children with obstructive sleep apnea during wakefulness and sleep

Joseph A. Crisalli, Keith McConnell, Rhonda D. VanDyke, Matthew C. Fenchel, Virend Somers, A. Shamszumann, Barbara Chini, Stephen R. Daniels, Raouf S. Amin

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Study Objectives: Children with obstructive sleep apnea have blunted baroreflex sensitivity and increased blood pressure variability. The aim of the study was to test the hypothesis that treatment of sleep apnea by adenotonsillectomy results in significant improvement of baroreflex sensitivity, lowering of blood pressure and blood pressure variability and increase vagal heart rate modulation. Study Design: One hundred ninety-four children aged 9.6 ± 2.3 years were enrolled; 133 had obstructive sleep apnea and 61 were healthy controls. For children with sleep apnea, polysomnography with 3-lead electrocardiography and continuous blood pressure was performed before adenotonsillectomy, then 6 weeks and 6 months postoperatively. Controls underwent the same assessment at study entry and 6 months later. Spontaneous baroreflex sensitivity was measured in the time and frequency domains. Data analyses were performed for available and complete cases. Results: Children with sleep apnea experienced postoperatively an increase in baroreflex sensitivity and decrease in blood pressure variability during wakefulness and sleep. A decrease in blood pressure during sleep and in heart rate during wakefulness was also measured. The improvement in baroreflex sensitivity was predicted by the change in the apnea-hypopnea and arousal indices. A normal pattern of rising baroreflex sensitivity during the night was restored in children with severe apnea after surgery. However, baroreceptor sensitivity did not completely normalize after treatment. Conclusion: Treatment of obstructive sleep apnea in children by adenotonsillectomy is associated with gradual improvement in known risk factors for cardiovascular disease. Complete normalization of baroreceptor sensitivity was not achieved 6 months postoperatively.

Original languageEnglish (US)
Pages (from-to)1335-1343
Number of pages9
JournalSleep
Volume35
Issue number10
DOIs
StatePublished - Oct 1 2012

Fingerprint

Baroreflex
Wakefulness
Obstructive Sleep Apnea
Sleep
Blood Pressure
Sleep Apnea Syndromes
Pressoreceptors
Apnea
Heart Rate
Polysomnography
Arousal
Electrocardiography
Cardiovascular Diseases
Therapeutics

Keywords

  • Baroreflex
  • Blood pressure variability
  • Hypertension
  • Sleep apnea
  • Tonsillectomy

ASJC Scopus subject areas

  • Physiology (medical)
  • Clinical Neurology

Cite this

Crisalli, J. A., McConnell, K., VanDyke, R. D., Fenchel, M. C., Somers, V., Shamszumann, A., ... Amin, R. S. (2012). Baroreflex sensitivity after adenotonsillectomy in children with obstructive sleep apnea during wakefulness and sleep. Sleep, 35(10), 1335-1343. https://doi.org/10.5665/sleep.2108

Baroreflex sensitivity after adenotonsillectomy in children with obstructive sleep apnea during wakefulness and sleep. / Crisalli, Joseph A.; McConnell, Keith; VanDyke, Rhonda D.; Fenchel, Matthew C.; Somers, Virend; Shamszumann, A.; Chini, Barbara; Daniels, Stephen R.; Amin, Raouf S.

In: Sleep, Vol. 35, No. 10, 01.10.2012, p. 1335-1343.

Research output: Contribution to journalArticle

Crisalli, JA, McConnell, K, VanDyke, RD, Fenchel, MC, Somers, V, Shamszumann, A, Chini, B, Daniels, SR & Amin, RS 2012, 'Baroreflex sensitivity after adenotonsillectomy in children with obstructive sleep apnea during wakefulness and sleep', Sleep, vol. 35, no. 10, pp. 1335-1343. https://doi.org/10.5665/sleep.2108
Crisalli, Joseph A. ; McConnell, Keith ; VanDyke, Rhonda D. ; Fenchel, Matthew C. ; Somers, Virend ; Shamszumann, A. ; Chini, Barbara ; Daniels, Stephen R. ; Amin, Raouf S. / Baroreflex sensitivity after adenotonsillectomy in children with obstructive sleep apnea during wakefulness and sleep. In: Sleep. 2012 ; Vol. 35, No. 10. pp. 1335-1343.
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