Correlates of respiratory cycle-related EEG changes in children with sleep-disordered breathing
Ronald D Chervin1, Joseph W Burns, Nikolas S Subotic
1Sleep Disorders Center and Department of Neurology, University of Michigan, Ann Arbor, Mich, USA. chervin@umich.edu
Study Objectives:
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).
Design:
Retrospective.
Setting:
University sleep laboratory.
Participants:
Ten research subjects, aged 6 to 10 years, with and without SDB.
Intervention:
Polysomnography, Multiple Sleep Latency Tests, and tests of auditory attention before and after clinically-indicated tonsillectomy (n = 9) or hernia repair (n = 1, control).
Measurements:
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.
Results:
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).
Conclusions:
The RCREC may reflect brief but numerous microarousals that could help to explain neurobehavioral consequences of SDB.
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