• Mathias Baumert, Yvonne Pamula, Mark Kohler, James Martin, Declan Kennedy, Eugene Nalivaiko, and Sarah A Immanuel.
• School of Electrical and Electronic Engineering, University of Adelaide, Adelaide, Australia. Electronic address: mathias.baumert@adelaide.edu.au.
• Sleep Med. 2015 May 1; 16 (5): 665-7.

ObjectiveHeartbeat-evoked potentials (HEPs) in electroencephalogram (EEG) provide a quantitative measure of cardiac interoception during sleep. We previously reported reduced HEPs in children with sleep-disordered breathing (SDB), indicative of attenuated cardiac information processing. The objective of this study was to investigate the link between HEP and respiration.Patients/MethodsFrom the overnight polysomnograms of 40 healthy children and 40 children with SDB, we measured HEPs during epochs of stage 2, slow-wave and rapid eye movement (REM) sleep free of abnormal respiratory events. HEPs were analysed with respect to respiratory phase.ResultsWe observed a marked association between respiratory phase and HEP in children with SDB during REM sleep, but not in normal children. In children with SDB, HEP waveforms were attenuated during expiration compared to inspiration. Following adenotonsillectomy, expiratory HEP peak amplitude increased in the SDB children and was no longer different from those of normal children.ConclusionsThe expiratory phase of respiration is primarily associated with attenuated cardiac information processing in children with SDB, establishing a pathophysiological link between breathing and HEP attenuation.Copyright © 2015 Elsevier B.V. All rights reserved.

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