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Reduced NREM sleep instability in children with sleep disordered breathing

Leila Kheirandish-Gozal1, Silvia Miano, Oliviero Bruni

  • 1Division of Pediatric Sleep Medicine, Kosair Children's Hospital Research Institute, University of Louisville, Louisville, KY 40202, USA.

Sleep
|May 25, 2007
PubMed

Insights

Children with sleep disordered breathing (SDB) or obstructive sleep apnea (OSA) exhibit altered NREM sleep instability, indicated by reduced cyclic alternating pattern (CAP) rates and entropy.

Area of Science:

  • Pediatric Sleep Medicine
  • Neurophysiology
  • Respiratory Medicine

Background:

  • Sleep disordered breathing (SDB) and obstructive sleep apnea (OSA) are common in children.
  • NREM sleep instability, quantified by cyclic alternating pattern (CAP), may reflect underlying sleep disturbances.
  • Subtle sleep alterations in pediatric SDB/OSA may impact neurocognitive function.

Purpose of the Study:

  • To assess NREM sleep instability using CAP in children with mild SDB or OSA compared to controls.
  • To investigate if CAP parameters differ between children with SDB/OSA and healthy children.
  • To explore potential correlations between sleep instability and neurocognitive outcomes.

Main Methods:

  • Prospective observational study in a sleep laboratory.
  • Polysomnography was performed on 22 children with SDB/OSA and 15 age-matched controls.
  • Sleep macrostructure and CAP were visually scored, with Markovian analysis applied.

Main Results:

  • Children with OSA showed significantly reduced total CAP rates compared to controls and mild SDB.
  • Mild SDB and OSA groups had lower A1 phase number, percentage, and index.
  • OSA patients exhibited longer intervals between A phases and decreased Markovian entropy.

Conclusions:

  • Reduced CAP rates and altered entropy in pediatric SDB/OSA suggest subtle NREM sleep instability.
  • These findings may offer objective markers for neurocognitive and behavioral issues in children who snore.
  • CAP analysis provides a sensitive tool for detecting sleep alterations not evident through standard scoring.
Abstract

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