LAUSR

Background Autonomic dysfunction is a key trait in the development of obstructive sleep apnea syndrome (OSAS) in adults. However, few similar studies focused on children and adolescents. We investigated if there was any association between heart rate recovery (HRR) and the severity of OSAS in children and adolescents. Methods A total of 161 subjects were included: 87 healthy controls, 35 mild OSAS patients (M-OSAS) and 39 moderate-severe OSAS (M-S-OSAS) patients. Clinical parameters, cardiopulmonary exercise test (CPET) indexes including HRR and polysomnographic records including apnea−hypopnea index (AHI) were compared among the three groups. Pearson correlation analysis and multivariable linear regression analysis were used to detect the relationship between HRR and polysomnographic parameters. Results HRR values in either the OSAS group were lower than those of the control group, and the values in the M-S OSAS group were even lower than those of the M-OSAS group ( P  < 0.05). Correlation analysis showed that HRR was inversely correlated with AHI ( r  = −0.190, P  < 0.01). Moreover, multivariable linear regression analyses showed the association between HRR and AHI was significant ( β  = 0.174, P  < 0.01). Conclusions HRR was closely associated with OSAS severity, which suggested that HRR might be a promising index for risk stratification and clinical management in children and adolescents with OSAS. Impact Heart rate recovery (HRR), a noninvasive and reliable index of automatic nervous system, is closely associated with the severity of obstructive sleep apnea syndrome (OSAS) in children and adolescents. To our knowledge, our study was the first study in China focusing on evaluating the role of HRR in children with OSAS. We found HRR was closely associated with OSAS severity in children and adolescents, and it suggested that HRR might be a promising index for risk stratification and clinical management in children and adolescents with OSAS.