Using sleep heart rate variability to investigate the sleep quality in children with obstructive sleep apnea

Lee, Li‐Ang; Chuang, Hai‐Hua; Hsieh, Hui‐Shan; Wang, Chao-Yung; Chuang, Li‐Pang; Li, Hsueh‐Yu; Fang, Tuan‐Jen; Huang, Yu‐Shu; Lee, Guo She; Yang, Albert C.; Kuo, Terry B.J.; Yang, Cheryl C.H.

doi:10.3389/fpubh.2023.1103085

Cited by 6 publications

(3 citation statements)

References 66 publications

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“…Secondly, heart rate variability (HRV) has been recently described as an OSA-specific biomarker, with promising results in evaluating treatment efficacy in children [ 70 , 71 , 72 , 73 ]. HRV corresponds to variations in the heart rate (HR) or beat-beat time interval due to the modulation of the autonomic nervous system’s activity.…”

Section: Discussionmentioning

confidence: 99%

“…HRV corresponds to variations in the heart rate (HR) or beat-beat time interval due to the modulation of the autonomic nervous system’s activity. Because OSA sleep fragmentation and hypoxemia may increase the sympathetic nervous system’s activity, HRV analysis could evaluate these characteristic variations produced by OSA [ 72 , 74 ].…”

Section: Discussionmentioning

confidence: 99%

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Diagnosis and Treatment of Sleep Apnea in Children: A Future Perspective Is Needed

Solano-Pérez,

Coso,

Castillo-García

et al. 2023

Biomedicines

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Obstructive sleep apnea (OSA) in children is a prevalent, but still, today, underdiagnosed illness, which consists of repetitive episodes of upper airway obstruction during sleep with important repercussions for sleep quality. OSA has relevant consequences in the pediatric population, mainly in the metabolic, cardiovascular (CV), and neurological spheres. However, contrary to adults, advances in diagnostic and therapeutic management have been scarce in the last few years despite the increasing scientific evidence of the deleterious consequences of pediatric OSA. The problem of underdiagnosis and the lack of response to treatment in some groups make an update to the management of OSA in children necessary. Probably, the heterogeneity of OSA is not well represented by the classical clinical presentation and severity parameters (apnea/hypopnea index (AHI)), and new strategies are required. A specific and consensus definition should be established. Additionally, the role of simplified methods in the diagnosis algorithm should be considered. Finally, the search for new biomarkers for risk stratification is needed in this population. In conclusion, new paradigms based on personalized medicine should be implemented in this population.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Diagnosis and Treatment of Sleep Apnea in Children: A Future Perspective Is Needed

Solano-Pérez,

Coso,

Castillo-García

et al. 2023

Biomedicines

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“…Following the 2012 American Academy of Sleep Medicine Manual guidelines ( 39 ), we employed standard full-night in-lab polysomnography. The detailed protocol for this polysomnography has been previously documented ( 37 , 40 , 41 ).…”

Section: Methodsmentioning

confidence: 99%

Comparative analysis of gut microbiota in children with obstructive sleep apnea: assessing the efficacy of 16S rRNA gene sequencing in metabolic function prediction based on weight status

Chuang,

Huang,

Chou

et al. 2024

Front. Endocrinol.

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BackgroundAnalyzing bacterial microbiomes consistently using next-generation sequencing (NGS) is challenging due to the diversity of synthetic platforms for 16S rRNA genes and their analytical pipelines. This study compares the efficacy of full-length (V1–V9 hypervariable regions) and partial-length (V3–V4 hypervariable regions) sequencing of synthetic 16S rRNA genes from human gut microbiomes, with a focus on childhood obesity.MethodsIn this observational and comparative study, we explored the differences between these two sequencing methods in taxonomic categorization and weight status prediction among twelve children with obstructive sleep apnea.ResultsThe full-length NGS method by Pacbio® identified 118 genera and 248 species in the V1–V9 regions, all with a 0% unclassified rate. In contrast, the partial-length NGS method by Illumina® detected 142 genera (with a 39% unclassified rate) and 6 species (with a 99% unclassified rate) in the V3–V4 regions. These approaches showed marked differences in gut microbiome composition and functional predictions. The full-length method distinguished between obese and non-obese children using the Firmicutes/Bacteroidetes ratio, a known obesity marker (p = 0.046), whereas the partial-length method was less conclusive (p = 0.075). Additionally, out of 73 metabolic pathways identified through full-length sequencing, 35 (48%) were associated with level 1 metabolism, compared to 28 of 61 pathways (46%) identified through the partial-length method. The full-length NGS also highlighted complex associations between body mass index z-score, three bacterial species (Bacteroides ovatus, Bifidobacterium pseudocatenulatum, and Streptococcus parasanguinis ATCC 15912), and 17 metabolic pathways. Both sequencing techniques revealed relationships between gut microbiota composition and OSA-related parameters, with full-length sequencing offering more comprehensive insights into associated metabolic pathways than the V3–V4 technique.ConclusionThese findings highlight disparities in NGS-based assessments, emphasizing the value of full-length NGS with amplicon sequence variant analysis for clinical gut microbiome research. They underscore the importance of considering methodological differences in future meta-analyses.

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Alterations of Gut Microbiome Composition and Function Pre- and Post-Adenotonsillectomy in Children with Obstructive Sleep Apnea

Chuang,

Lee,

Chuang

et al. 2024

Journal of Otolaryngology - Head & Neck Surgery

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Importance Obstructive sleep apnea (OSA) in children is linked with alterations in the gut microbiome. The influence of adenotonsillectomy (AT), a primary intervention for OSA, on gut microbiota dynamics relative to disease severity remains to be elucidated. Objective This study aimed to investigate the impact of OSA severity and AT on the gut microbiome in pediatric patients. Design A prospective observational study. Setting Tertiary referral center. Participants A cohort of 55 pediatric patients treated with AT for OSA. Intervention Total tonsillectomy and adenoidectomy procedures. Main Outcome Measures Comprehensive evaluations included in-laboratory polysomnography and 16S rRNA gut microbiome profiling at baseline, and again at 3rd and 12thmonth following surgery. Results Initial findings showed uniform α-diversity across different severities of OSA, while β-diversity was significantly elevated in the severe OSA subgroup. Certain gut microbiota taxa ( Lachnospiraceae NK4A136 group, Ruminococcaceae UCG-002, Ruminococcaceae UCG-014, Alloprevotella, Christensenellaceae R-7 group, Ruminococcaceae UCG-005, Lactobacillus murinus, and Prevotella nigrescens) were found to inversely correlate with the apnea-hypopnea index (AHI). Significant post-AT improvements in AHI and other polysomnographic metrics were observed. Notably, AHI changes post-AT were positively associated with microbial α-diversity (species richness), β-diversity, and specific bacterial taxa ( Enterobacter, Parasutterella, Akkermansia, Roseburia, and Bacteroides plebeius DSM 17135), but negatively with other taxa ( Fusicatenibacter, Bifidobacterium, UBA1819, Ruminococcus gnavus group, Bifidobacterium longum subsp. Longum, and Parabacteroides distasonis) and specific metabolic pathways (purine metabolism, transcription factors, and type II diabetes mellitus). The postoperative patterns of α- and β-diversity mirrored baseline values. Conclusions and Relevance This study documents significant changes in the gut microbiome of pediatric patients after AT, including variations in α- and β-diversities, bacterial communities, and inferred metabolic functions. These changes suggest a potential association between the surgical intervention and microbiome alterations, although further studies are necessary to discern the specific contributions of AT amidst possible confounding factors such as antibiotic use.

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Using sleep heart rate variability to investigate the sleep quality in children with obstructive sleep apnea

Cited by 6 publications

References 66 publications

Diagnosis and Treatment of Sleep Apnea in Children: A Future Perspective Is Needed

Diagnosis and Treatment of Sleep Apnea in Children: A Future Perspective Is Needed

Comparative analysis of gut microbiota in children with obstructive sleep apnea: assessing the efficacy of 16S rRNA gene sequencing in metabolic function prediction based on weight status

Alterations of Gut Microbiome Composition and Function Pre- and Post-Adenotonsillectomy in Children with Obstructive Sleep Apnea

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