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Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
07:54

Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea

Published on: December 6, 2016

Subcortical arousal response in child patients with obstructive sleep apnea

Jun Kohyama1, Takeshi Hasegawa

  • 1Department of Pediatrics, Tokyo Medical and Dental University, 1-5-45 Yushima, Tokyo 113-8519, Japan. jkohyama.ped@tmd.ac.jp

Sleep Medicine
|November 1, 2003
PubMed

Insights

Subcortical arousal responses (SCAs) are elevated in children with obstructive sleep apnea syndrome (OSAS). Treatment significantly reduces SCA short and intermediate types, indicating their utility in assessing subcortical involvement.

Area of Science:

  • Pediatric Pulmonology
  • Sleep Medicine
  • Neurology

Background:

  • Obstructive sleep apnea syndrome (OSAS) is prevalent in children.
  • Subcortical arousal responses (SCAs) are poorly understood in pediatric OSAS.
  • A novel index, SCA, involving sighs and elevated chin muscle activity, was developed.

Purpose of the Study:

  • To assess subcortical arousal response (SCA) in children with OSAS.
  • To evaluate the impact of adenotonsillectomy on SCA.
  • To compare SCA incidence in OSAS patients and controls.

Main Methods:

  • Defined SCA as a sigh with elevated chin muscle activity.
  • Classified SCAs into short (1-3s), intermediate (3-10s), and long (>10s) durations.
  • Scored SCAs in 6 child OSAS patients (aged 2-5) before and after adenotonsillectomy, and in 4 controls.

Main Results:

  • Pre-treatment, 45.5% of SCAs were linked to electroencephalographic arousals.
  • SCA short and intermediate significantly decreased post-treatment, reaching control levels.
  • SCA long showed no consistent post-treatment changes. SCA incidence exceeded previously reported arousal levels.

Conclusions:

  • SCAs, particularly short and intermediate types, are sensitive indicators of subcortical involvement in pediatric OSAS.
  • SCA provides a valuable metric for assessing treatment response in child OSAS patients.
  • The high incidence of SCAs suggests a significant subcortical component in pediatric OSAS.
Abstract

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