Correlates of respiratory cycle-related EEG changes in children with sleep-disordered breathing

• Published in: Sleep (New York, N.Y.) Vol. 27; no. 1; pp. 116 - 121
• Main Authors: CHERVIN, Ronald D, BURNS, Joseph W, SUBOTIC, Nikolas S, ROUSSI, Christopher, THELEN, Brian, RUZICKA, Deborah L
• Format: Journal Article
• Language: English
• Published: Rochester, MN American Academy of Sleep Medicine 01-02-2004
• Subjects: Algorithms; Biological and medical sciences; Child; Child, Preschool; Electroencephalography; Female; Humans; Male; Medical sciences; Non tumoral diseases; Otorhinolaryngology. Stomatology; Periodicity; Postoperative Care; Preoperative Care; Respiration; Retrospective Studies; Severity of Illness Index; Sleep Apnea Syndromes - diagnosis; Sleep Apnea Syndromes - etiology; Sleep Apnea, Obstructive - complications; Sleep Apnea, Obstructive - diagnosis; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology; Human; Vigilance; Sleep apnea syndrome; Upper respiratory tract; Auditory attention; Asleeping; Electroencephalography; Polysomnography; Obstruction; Latency; Hernia; Electrodiagnosis; Somnolence; Tonsillectomy; Surgery; ENT disease; Developmental stage; Child
• ISSN: 0161-8105; 1550-9109
• DOI: 10.1093/sleep/27.1.116

To explore newly-identified respiratory cycle-related electroencephalographic changes (RCREC), which may represent microarousals, as correlates of neurobehavioral outcomes in children with sleep-disordered breathing (SDB).
Retrospective.
University sleep laboratory.
Ten research subjects, aged 6 to 10 years, with and without SDB.
Polysomnography, Multiple Sleep Latency Tests, and tests of auditory attention before and after clinically-indicated tonsillectomy (n = 9) or hernia repair (n = 1, control).
For the first 3 hours of nocturnal sleep, a computer algorithm quantified the degree to which delta, theta, and alpha electroencephalographic power varied within non-apneic respiratory cycles. Correlations between the RCREC and standard objective measures of SDB, sleepiness, and attention were explored.
Five children had SDB (> 1 obstructive apnea per hour of sleep). Preoperative delta, theta, or alpha RCREC were statistically significant (P < .01) in all subjects except 1 without SDB and the 1 control. Theta RCREC correlated with rates of apneas and hypopneas (P = .01) and decreased after the apnea was treated. Postoperative changes in delta and theta RCREC predicted changes in Multiple Sleep Latency Test scores (rho = -0.84, P = .002; rho = -0.64, P = .05), whereas changes in rates of apneas and hypopneas did not (rho = -0.24, P = .50). Postoperative changes in attention tended to correlate with changes in delta RCREC (rho = -0.54, P = .11) more strongly than with changes in rates of apneic events (rho = -0.07, P = .84).
The RCREC may reflect brief but numerous microarousals that could help to explain neurobehavioral consequences of SDB.