Sleep physiological network analysis in children

Objective: Physiological networks have recently been employed as an alternative to analyze the interaction of the human body. Within this option, different systems are analyzed as nodes inside a communication network as well how information fows. Several studies have been proposed to study sleep subjects with the help of the Granger causality computation over electroencephalographic and heart rate variability signals. However, following this methodology, novel approximations for children subjects are presented here, where comparison between adult and children sleep is followed through the obtained connectivities. Methods: Data from ten adults and children were retrospectively extracted from polysomnography records. Database was extracted from people suspected of having sleep disorders who participated in a previous study. Connectivity was computed based on Granger causality, according to preprocessing of similar studies in this feld. A comparison for adults and children groups with a chi-square test was followed, employing the results of the Granger causality measures. Results: Results show that differences were mainly established for nodes inside the brain network connectivity. Additionally, for interactions between brain and heart networks, it was brought to light that children physiology sends more information from heart to brain nodes compared to the adults group. Discussion: This study represents a frst sight to children sleep analysis, employing the Granger causality computation. It contributes to understand sleep in children employing measurements from physiological signals. Preliminary fndings suggest more interactions inside the brain network for children group compared to adults group

Impulse oscillometry reference values and bronchodilator response in three- to five-year old children living at high altitude

Q2Q1Introduction: Impulse oscillometry (IOS) is used to measure airway impedance. It is an effective tool for diagnosing and treating respiratory diseases, and it has the advantage that it does not require forced respiratory maneuvers. IOS reference values are required for each population group. Objective: This study aimed to determine the IOS reference values and bronchodilator response in healthy preschool children living in Bogotá, Colombia. Methods: We performed a cross-sectional study in preschool children who had no history of respiratory disease; 96 children fit the parameters for testing to determine normal values according to the American Thoracic Society and European Respiratory Society criteria. Results: Values for respiratory resistance (Rrs) and reactance (Xrs) at 5, 10, and 20 Hz, respiratory impedance (Zrs, and resonance frequency (Fres) were established. Height was the most influential independent variable for IOS values; an increase in height led to a reduction in Rrs5 and Rrs20 and an increase in Xrs5. After the administration of 400 mcg of salbutamol the values for Rrs5(-17.48%), Rrs20(-8.63%), Fres (-10.68%), and area of reactance (-35.44%) were reduced, meanwhile Xrs5 (15.35%) was increased. Conclusions: Normal IOS values before and after the administration of 400 mcg of salbutamol were determined for a population of children aged 3-5 years at 2,640 m. Reference IOS equations for these children are presented. A relative change of up to -28% and 36% after the use of salbutamol for respiratory resistance and reactance, respectively, should be considered as an upper limit of the normal range, and possible appropriate cut-off values for defining significant response for evaluating therapeutic interventions. Keywords: children; cross-sectional studies; high altitude; oscillometry; reference values; respiratory function tests.N/

Hipoxia intermitente y patrones respiratorios durante el sueño de bebés prematuros de 3 a 18 meses que residen a gran altura.

9 páginasStudy Objectives: The aim of this study was to determine the impact of apneas on oxygen saturation and the presence of intermittent hypoxia, during sleep of preterm infants (PTIs) born at high altitudes and compare with full-term infants (FTIs) at the same altitude. Methods: PTIs and FTIs from 3 to 18 months were included. They were divided into three age groups: 3–4 months (Group 1); 6–7 months (Group 2), and 10–18 months (Group 3). Polysomnography parameters and oxygenation indices were evaluated. Intermittent hypoxia was defined as brief, repetitive cycles of decreased oxygen saturation. Kruskal-Wallis test for multiple comparisons, t-test or Mann–Whitney U-test were used. Results: 127 PTI and 175 FTI were included. Total apnea-hypopnea index (AHI) was higher in PTI that FTI in all age groups (Group 1: 33.5/h vs. 12.8/h, p = 0.042; Group 2: 27.0/h vs. 7.4/h, p < 0.001; and Group 3: 11.6/h vs. 3.1/h, p < 0.001). In Group 3, central-AHI (8.0/h vs. 2.3/h, p < 0.001) and obstructive-AHI (1.8/h vs. 0.6/h, p < 0.008) were higher in PTI than FTI. T90 (7.0% vs. 0.5, p < 0.001), oxygen desaturation index (39.8/h vs. 11.3, p < 0.001) were higher in PTI than FTI, nadir SpO2 (70.0% vs. 80.0, p<0.001) was lower in PTI. Conclusion: At high altitude, compared to FTI, PTI have a higher rate of respiratory events, greater desaturation, and a delayed resolution of these conditions, suggesting the persistence of intermittent hypoxia during the first 18 months of life. This indicates the need for follow-up of these infants for timely diagnosis and treatment of respiratory disturbances during sleep.Objetivos del estudio: El objetivo de este estudio fue determinar el impacto de las apneas en la saturación de oxígeno y la presencia de síntomas intermitentes. hipoxia, durante el sueño de bebés prematuros (PTI) nacidos a gran altura y en comparación con bebés a término (FTI) a la misma altitud. Métodos: Se incluyeron PTI y FTI de 3 a 18 meses. Se dividieron en tres grupos de edad: 3 a 4 meses (Grupo 1); 6–7 meses (Grupo 2) y de 10 a 18 meses (Grupo 3). Se evaluaron parámetros de polisomnografía e índices de oxigenación. La hipoxia intermitente fue definido como ciclos breves y repetitivos de disminución de la saturación de oxígeno. Prueba de Kruskal-Wallis para comparaciones múltiples, prueba t o Mann-Whitney Se utilizó la prueba U. Resultados: Se incluyeron 127 PTI y 175 FTI. El índice total de apnea-hipopnea (IAH) fue mayor en PTI que en FTI en todos los grupos de edad (Grupo 1: 33,5/h vs. 12,8/h, p = 0,042; Grupo 2: 27,0/h vs. 7,4/h, p < 0,001; y Grupo 3: 11,6/h vs. 3,1/h, p < 0,001). En el grupo 3, IAH central (8,0/h vs. 2,3/h, p < 0,001) y el IAH obstructivo (1,8/h frente a 0,6/h, p < 0,008) fueron mayores en PTI que en FTI. T90 (7,0% vs. 0,5, p < 0,001), índice de desaturación de oxígeno (39,8/h vs. 11,3, p < 0,001) fueron mayores en PTI que en FTI, nadir SpO2 (70,0% vs. 80,0, p<0,001) fue menor en PTI. Conclusión: A gran altitud, en comparación con FTI, los PTI tienen una mayor tasa de eventos respiratorios, mayor desaturación y una resolución tardía de estas condiciones, lo que sugiere la persistencia de hipoxia intermitente durante los primeros 18 meses de vida. Esto indica la necesidad de realizar un seguimiento estos bebés para el diagnóstico y tratamiento oportuno de las alteraciones respiratorias durante el sueño