Faculty Collaboration Database

Pupillometric findings in children with obstructive sleep apnea. Sleep Med 2015 Oct;16(10):1187-91

Date

10/03/2015

Pubmed ID

26429743

Pubmed Central ID

PMC4592513

DOI

10.1016/j.sleep.2015.06.001

Scopus ID

2-s2.0-84942524686 (requires institutional sign-in at Scopus site)   6 Citations

Abstract

BACKGROUND: Obstructive sleep apnea (OSA) leads to intermittent hypoxia, activation of the sympathetic nervous system, and eventually cardiovascular morbidity. Alterations in autonomic nervous system (ANS) tone and reflexes are likely to play major roles in OSA-associated morbidities, and have been identified in a subset of children with OSA.

OBJECTIVES: To evaluate whether pupillometry, a noninvasive and rapid bedside test for the assessment of autonomic nervous system dysfunction (ANS), would detect abnormal ANS function in children with OSA.

METHODS: Children ages 2-12 years underwent polysomnography (PSG), and were divided based on PSG findings into two groups; Habitual Snorers (HS; AHI < 1 h/TST, n = 17) and OSA (AHI > 1 h/TST, n = 49), the latter then sub-divided into AHI severity categories (>1 but <5, >5 but <10, and >10 h/TST). Pupillometric measurements were performed during the clinic visit in a dark room using an automated pupillometer device.

RESULTS: A total of 66 subjects with a mean age of 7.3 ± 2.6 years were recruited. There were no statistically significant differences between any of the groups, even when comparing severe OSA (n = 15) and HS in any of the measures related to pupillary reflexes. However, mild, yet significant increases in systolic blood pressure and morning plasma norepinephrine levels were detected in the severe OSA group.

CONCLUSION: Although ANS perturbations are clearly present in a proportion of children with OSA, particularly those with severe disease, pupillary responses do not appear to provide a sensitive method for the detection of ANS dysfunction in OSA children.

Author List

Philby MF, Aydinoz S, Gozal D, Kilic S, Bhattacharjee R, Bandla HP, Kheirandish-Gozal L

Author

Hari Bandla MD Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Autonomic Nervous System
Child
Child, Preschool
Female
Humans
Male
Polysomnography
Reflex, Pupillary
Severity of Illness Index
Sleep Apnea, Obstructive