Involvement of autonomic nervous activity changes in gastroesophageal reflux in neonates during sleep and wakefulness

PloS One
Djamal-Dine DjeddiFrédéric Telliez

Abstract

It has been suggested that disturbed activity of the autonomic nervous system is one of the factors involved in gastroesophageal reflux (GER) in adults. We sought to establish whether transient ANS dysfunction (as assessed by heart rate variability) is associated with the occurrence of GER events in neonates during sleep and wakefulness. Nineteen neonates with suspected GER underwent simultaneous, synchronized 12-hour polysomnography and esophageal multichannel impedance-pH monitoring. We compared changes in HRV parameters during three types of periods (control and prior to and during reflux) with respect to the vigilance state. The vigilance state influenced the distribution of GER events (P<0.001), with 53.4% observed during wakefulness, 37.6% observed during active sleep and only 9% observed during quiet sleep. A significant increase in the sympathovagal ratio (+32%, P=0.013) was observed in the period immediately prior to reflux (due to a 15% reduction in parasympathetic activity (P=0.017)), relative to the control period. This phenomenon was observed during both wakefulness and active sleep. Our results showed that GER events were preceded by a vigilance-state-independent decrease in parasympathetic tone. This suggests tha...Continue Reading

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Citations

Feb 27, 2017·Advances in Medical Sciences·Jan Krzysztof NowakJarosław Walkowiak
Jun 10, 2019·European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery·A Min WangXian Ming Chen
Jun 27, 2020·International Journal of Environmental Research and Public Health·Chun-Gu ChengChun-An Cheng

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