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J Appl Physiol (May 2, 2003). doi:10.1152/japplphysiol.00354.2002
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Submitted on April 22, 2002
Accepted on April 25, 2003

Nasal CPAP treatment improves abnormal cardiovascular autonomic function and arousability in ALTE and SIDS-related infants with OSA

Carmel Harrington1*, Turkka Kirjavainen2, Arthur Teng3, and Colin E Sullivan2

1 Respiratory Medicine, University of Sydney, Sydney, NSW, Australia; Sleep Unit, Sydney Children's Hospital, Sydney, NSW, Australia
2 Respiratory Medicine, University of Sydney, Sydney, NSW, Australia
3 Sleep Unit, Sydney Children's Hospital, Sydney, NSW, Australia

* To whom correspondence should be addressed. E-mail: cth{at}med.usyd.edu.au.

We evaluated cardiovascular autonomic control and arousability during sleep in infants with obstructive sleep apnea (OSA) before and after 10 (SD 4) days of treatment with nasal continuous positive airway pressure (n-CPAP). Six OSA infants and twelve age-matched control infants were studied with polygraphic sleep studies at the age of 13 (SD 4) weeks. During the study, 45° head-up tilt tests were performed in slow wave (SWS) and rapid eye movement (REM) sleep. Blood pressure (BP) and heart rate (HR) were continuously monitored. All OSA infants had decreased initial BP and HR responses followed by hypotension in two and hypertension in two. OSA infants displayed higher arousal thresholds in response to the tilt in REM (p<0.005) and higher baseline HR (p<0.05) than controls. N-CPAP treatment normalized BP and HR responses as well as arousal thresholds to tilting, and stabilized HR levels. OSA in infants may be linked with cardiovascular autonomic control disturbances and decreased arousability during sleep. These defects are improved by control of OSA with n-CPAP.




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