Cardiac autonomic activity during sleep in high-altitude resident children compared with lowland residents

Catherine Mary Hill, Romola Starr Bucks, Nicola Cellini, Shayan Motamedi, Annette Carroll, Kate Heathcote, Rebecca Webster, David Simpson

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Abstract

Study Objectives: We aimed to characterize heart-rate variability (HRV) during sleep in Andean children native to high altitude (HA) compared with age, gender, and genetic ancestry-similar low-altitude (LA) children. We hypothesized that the hypoxic burden of sleep at HA could induce variation in HRV. As children have otherwise healthy cardiovascular systems, such alterations could provide early markers of later cardiovascular disease. Methods: Twenty-six LA (14F) and 18 HA (8F) children underwent a single night of attended polysomnography. Sleep parameters and HRV indices were measured. Linear mixed models were used to assess HRV differences across sleep stage and altitude group. Results: All children showed marked fluctuations in HRV parameters across sleep stages, with higher vagal activity during nonrapid eye movement sleep and greater variability of the heart rate during rapid eye movement (REM). Moreover, HA children showed higher very low-frequency HRV in REM sleep and, after adjusting for heart rate, higher low-to-high frequency ratio in REM sleep compared with children living at lower altitude. Conclusions: We confirmed previous findings of a stage-dependent modulation of HRV in Andean children living at both HA and LA. Moreover, we showed subtle alteration of HRV in sleep in HA children, with intriguing differences in the very low-frequency domain during REM sleep. Whether these differences are the results of an adaptation to high-altitude living, or an indirect effect of differences in oxyhemoglobin saturation remains unclear, and further research is required to address these questions.

Original languageEnglish
JournalSleep
Volume41
Issue number12
DOIs
Publication statusPublished - 1 Dec 2018

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Sleep
Heart Rate
REM Sleep
Sleep Stages
Oxyhemoglobins
Polysomnography
Eye Movements
Cardiovascular System
Linear Models
Cardiovascular Diseases

Cite this

Hill, Catherine Mary ; Bucks, Romola Starr ; Cellini, Nicola ; Motamedi, Shayan ; Carroll, Annette ; Heathcote, Kate ; Webster, Rebecca ; Simpson, David. / Cardiac autonomic activity during sleep in high-altitude resident children compared with lowland residents. In: Sleep. 2018 ; Vol. 41, No. 12.
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title = "Cardiac autonomic activity during sleep in high-altitude resident children compared with lowland residents",
abstract = "Study Objectives: We aimed to characterize heart-rate variability (HRV) during sleep in Andean children native to high altitude (HA) compared with age, gender, and genetic ancestry-similar low-altitude (LA) children. We hypothesized that the hypoxic burden of sleep at HA could induce variation in HRV. As children have otherwise healthy cardiovascular systems, such alterations could provide early markers of later cardiovascular disease. Methods: Twenty-six LA (14F) and 18 HA (8F) children underwent a single night of attended polysomnography. Sleep parameters and HRV indices were measured. Linear mixed models were used to assess HRV differences across sleep stage and altitude group. Results: All children showed marked fluctuations in HRV parameters across sleep stages, with higher vagal activity during nonrapid eye movement sleep and greater variability of the heart rate during rapid eye movement (REM). Moreover, HA children showed higher very low-frequency HRV in REM sleep and, after adjusting for heart rate, higher low-to-high frequency ratio in REM sleep compared with children living at lower altitude. Conclusions: We confirmed previous findings of a stage-dependent modulation of HRV in Andean children living at both HA and LA. Moreover, we showed subtle alteration of HRV in sleep in HA children, with intriguing differences in the very low-frequency domain during REM sleep. Whether these differences are the results of an adaptation to high-altitude living, or an indirect effect of differences in oxyhemoglobin saturation remains unclear, and further research is required to address these questions.",
author = "Hill, {Catherine Mary} and Bucks, {Romola Starr} and Nicola Cellini and Shayan Motamedi and Annette Carroll and Kate Heathcote and Rebecca Webster and David Simpson",
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Hill, CM, Bucks, RS, Cellini, N, Motamedi, S, Carroll, A, Heathcote, K, Webster, R & Simpson, D 2018, 'Cardiac autonomic activity during sleep in high-altitude resident children compared with lowland residents' Sleep, vol. 41, no. 12. https://doi.org/10.1093/sleep/zsy181

Cardiac autonomic activity during sleep in high-altitude resident children compared with lowland residents. / Hill, Catherine Mary; Bucks, Romola Starr; Cellini, Nicola; Motamedi, Shayan; Carroll, Annette; Heathcote, Kate; Webster, Rebecca; Simpson, David.

In: Sleep, Vol. 41, No. 12, 01.12.2018.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Cardiac autonomic activity during sleep in high-altitude resident children compared with lowland residents

AU - Hill, Catherine Mary

AU - Bucks, Romola Starr

AU - Cellini, Nicola

AU - Motamedi, Shayan

AU - Carroll, Annette

AU - Heathcote, Kate

AU - Webster, Rebecca

AU - Simpson, David

PY - 2018/12/1

Y1 - 2018/12/1

N2 - Study Objectives: We aimed to characterize heart-rate variability (HRV) during sleep in Andean children native to high altitude (HA) compared with age, gender, and genetic ancestry-similar low-altitude (LA) children. We hypothesized that the hypoxic burden of sleep at HA could induce variation in HRV. As children have otherwise healthy cardiovascular systems, such alterations could provide early markers of later cardiovascular disease. Methods: Twenty-six LA (14F) and 18 HA (8F) children underwent a single night of attended polysomnography. Sleep parameters and HRV indices were measured. Linear mixed models were used to assess HRV differences across sleep stage and altitude group. Results: All children showed marked fluctuations in HRV parameters across sleep stages, with higher vagal activity during nonrapid eye movement sleep and greater variability of the heart rate during rapid eye movement (REM). Moreover, HA children showed higher very low-frequency HRV in REM sleep and, after adjusting for heart rate, higher low-to-high frequency ratio in REM sleep compared with children living at lower altitude. Conclusions: We confirmed previous findings of a stage-dependent modulation of HRV in Andean children living at both HA and LA. Moreover, we showed subtle alteration of HRV in sleep in HA children, with intriguing differences in the very low-frequency domain during REM sleep. Whether these differences are the results of an adaptation to high-altitude living, or an indirect effect of differences in oxyhemoglobin saturation remains unclear, and further research is required to address these questions.

AB - Study Objectives: We aimed to characterize heart-rate variability (HRV) during sleep in Andean children native to high altitude (HA) compared with age, gender, and genetic ancestry-similar low-altitude (LA) children. We hypothesized that the hypoxic burden of sleep at HA could induce variation in HRV. As children have otherwise healthy cardiovascular systems, such alterations could provide early markers of later cardiovascular disease. Methods: Twenty-six LA (14F) and 18 HA (8F) children underwent a single night of attended polysomnography. Sleep parameters and HRV indices were measured. Linear mixed models were used to assess HRV differences across sleep stage and altitude group. Results: All children showed marked fluctuations in HRV parameters across sleep stages, with higher vagal activity during nonrapid eye movement sleep and greater variability of the heart rate during rapid eye movement (REM). Moreover, HA children showed higher very low-frequency HRV in REM sleep and, after adjusting for heart rate, higher low-to-high frequency ratio in REM sleep compared with children living at lower altitude. Conclusions: We confirmed previous findings of a stage-dependent modulation of HRV in Andean children living at both HA and LA. Moreover, we showed subtle alteration of HRV in sleep in HA children, with intriguing differences in the very low-frequency domain during REM sleep. Whether these differences are the results of an adaptation to high-altitude living, or an indirect effect of differences in oxyhemoglobin saturation remains unclear, and further research is required to address these questions.

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U2 - 10.1093/sleep/zsy181

DO - 10.1093/sleep/zsy181

M3 - Article

VL - 41

JO - Sleep

JF - Sleep

SN - 0161-8105

IS - 12

ER -