Related Experiment Videos
Dynamic changes in EEG spectra during obstructive apnea in children
1Constance S. Kaufman Pediatric Pulmonary Research Laboratory, Tulane Comprehensive Sleep Medicine Center, Department of Pediatrics, Tulane University School of Medicine, New Orleans, LA, USA.
Insights
Pediatric obstructive sleep apnea (OSA) without arousal shows decreased delta EEG waves during obstruction, followed by a rebound. These changes diminish with repeated apnea, suggesting subtle sleep fragmentation in children.
Area of Science:
- Neurology
- Sleep Medicine
- Pediatric Pulmonology
Background:
- Obstructive sleep apnea (OSA) in children often lacks the EEG arousal seen in adults.
- Investigating spectral EEG changes during REM-associated OSA in children without arousal is crucial.
Purpose of the Study:
- To examine spectral EEG characteristics during REM-associated obstructive sleep apnea (OSA) in children, specifically in the absence of EEG or behavioral arousal.
- To determine if subtle EEG changes occur during and after isolated OSA events and repeated OSA clusters.
Main Methods:
- Overnight polysomnography was performed on eight snoring children.
- EEG signals from C3A2 and C4A1 leads were analyzed using Fast Fourier Transform (FFT) for epochs before, during, and after OSA events.
- Isolated OSA events and clusters of OSA events during REM sleep were analyzed.
Main Results:
- Isolated OSA events showed decreased delta wave amplitude during obstruction, with a subsequent increase post-obstruction.
- Repeated OSA events led to an attenuation of these delta wave dynamic changes.
- Theta frequency showed reciprocal changes, while sigma and beta frequencies remained unchanged.
Conclusions:
- Isolated, non-aroused OSA episodes in children are associated with selective delta frequency power decreases and subsequent rebound.
- The attenuation of delta changes during repeated OSA suggests adaptive mechanisms.
- These findings may indicate subtle arousal and sleep fragmentation in pediatric OSA.
Abstract:
Children are less likely to demonstrate EEG arousal during obstructive sleep apnea (OSA) than adults. We hypothesized that changes in spectral EEG characteristics occur during REM-associated OSA in the absence of arousal. Eight snoring children underwent overnight polysomnography. OSA events during REM periods not associated with EEG or behavioral arousal were identified. EEG signals from C3A2 and C4A1 leads corresponding to 1) < or =10-sec epochs preceding OSA (PRE), 2) the obstructed period (OSA), and 3) < or =10-sec epochs following airflow resumption (POST) were subjected to fast Fourier transform (FFT) routines. Seventy-two isolated OSA, and 14 clusters of > 4 OSA events were analyzed. In single OSA, delta OSA amplitude was lower than in PRE (P < 0.01) and in POST (P < 0.001). Furthermore, POST delta amplitude was higher than PRE (P < 0.01). In contrast, in OSA clusters, the dynamic differences in delta amplitude disappeared after the second OSA. Reciprocal increases and decreases occurred for the theta frequency domain during OSA and post-OSA, while sigma and beta frequency power did not change. We conclude that during isolated OSA episodes without arousal, significant decreases in power selectively occur for delta frequency, and are followed by a rebound increase upon termination of apnea. The delta changes are progressively attenuated during repeated OSA. We postulate that delta changes may reflect ongoing adaptations in sleep pressure which are necessary to relieve the respiratory compromise, and may represent subtle evidence for arousal and consequent sleep fragmentation in children with OSAS.