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Increased thoracoabdominal asynchrony during breathing periods free of discretely scored obstructive events in children with upper airway obstruction

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Abstract

Objective

This study aims to investigate the impact of upper airway obstruction (UAO) in children by measuring thoracoabdominal asynchrony (TAA) during periods of sleep apnea/hypopnea and during scored-event-free (SEF) breathing periods.

Methods

Respiratory inductive plethysmographic signals were extracted from polysomnographic data, recorded before and after adenotonsillectomy in 40 children with UAO and 40 healthy, matched children at equivalent time points. Thoracoabdominal asynchrony was computed using a Hilbert transform-based phase difference estimation method in SEF periods during stage 2, stage 4 non-rapid eye movement (NREM), and rapid eye movement (REM) sleep and compared between the groups.

Results

At baseline, in the UAO group, TAA during obstructions were significantly higher than TAA during SEF periods in both stage 2 and REM sleep. Compared to controls, children with UAO had a significantly higher TAA during SEF periods in stage 2, stage 4 sleep, and REM sleep. This between-group difference was not significant post adenotonsillectomy. UAO group showed a significant decrease in TAA compared to their baseline during SEF stage 2 and 4 NREM, but not in REM.

Conclusion

Upper airway obstruction in children is associated with increased TAA during SEF periods, indicative of continuous partial obstruction of the upper airway. Adenotonsillectomy decreased this effect significantly in non-REM sleep as evidenced by reduced asynchrony levels post-surgery. TAA assessment during sleep may therefore provide additional diagnostic information.

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Acknowledgments

MB holds a fellowship from the Australian Research Council, and this project was partly supported by grant ARC DP 110102049, DP 0663345, and NH&MRC project grant 250369.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. School of Electrical and Electronic Engineering, University of Adelaide, North Terrace Campus, SA, 5005, Adelaide, Australia

    Sarah A. Immanuel, Muammar M. Kabir & Mathias Baumert

  2. School of Psychology, Social Work and Social Policy, University of South Australia, Adelaide, Australia

    Mark Kohler

  3. Department of Respiratory and Sleep Medicine, Women’s and Children’s Hospital, Adelaide, Australia

    James Martin, Declan Kennedy & Yvonne Pamula

  4. Children’s Research Centre, School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, Australia

    Mark Kohler & Declan Kennedy

  5. School of Medical Sciences, University of Adelaide, Adelaide, Australia

    David A. Saint

Authors
  1. Sarah A. Immanuel
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  2. Mark Kohler
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  3. James Martin
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  4. Declan Kennedy
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  5. Yvonne Pamula
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  6. Muammar M. Kabir
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  7. David A. Saint
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  8. Mathias Baumert
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Correspondence to Sarah A. Immanuel.

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Immanuel, S.A., Kohler, M., Martin, J. et al. Increased thoracoabdominal asynchrony during breathing periods free of discretely scored obstructive events in children with upper airway obstruction. Sleep Breath 19, 65–71 (2015). https://doi.org/10.1007/s11325-014-0963-3

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  • DOI: https://doi.org/10.1007/s11325-014-0963-3

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