Abstract
This review addresses possible association between obstructive sleep apnea and risk of arrhythmias in children. Rapid-eye-movement sleep, in which obstructive apneas are most common in children, is characteristic for high risk of cardiac arrhythmias, and obstructive apneas increase these risks. Hypoxemia, hypercapnia, fluctuations in intrathoracic pressure, arousal reaction and sleep deprivation related to obstructive events, result in sympathetic activation, left atrium enlargement and to systemic inflammation, which increase the risk of arrhythmias. Brady-tachycardia is a typical phenomenon. These episodes may be detected by the means of cardiac rhythm monitoring. Marked signs of heart autonomic dysregulation are found against a background of obstructive sleep apneas. Increased sympathetic tone is associated with increased QT and P wave dispersion, which may predispose to ventricular and atrial arrhythmias. Pathological apneas may be accompanied by episodes of asystole and high-degree atrioventricular block. Thorough clinical investigation of children suspicious of having cardiac arrhythmias and sleep apneas is imperative for a proper therapeutic approach.
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About the authors
Igor’ A. Kel’manson, Dr. Med. Sci., Professor;
ORCID
