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Determining sleep quality in children with sleep disordered breathing: EEG spectral analysis compared with
Joel S C Yang1, Christian L Nicholas, Gillian M Nixon
1The Ritchie Centre, Monash Institute of Medical Research, Monash University, Victoria, Australia.
Insights
Sleep disordered breathing (SDB) in children shows minimal sleep disruption according to conventional scoring and EEG analysis. This suggests daytime issues in SDB children may stem from factors other than poor sleep quality.
Area of Science:
- Pediatric Sleep Medicine
- Neurology
- Respiratory Medicine
Background:
- Sleep disordered breathing (SDB) is common in children, often associated with daytime impairments.
- The impact of SDB severity on objective sleep quality remains incompletely understood.
Purpose of the Study:
- To quantify sleep disruption in children with varying SDB severity.
- To compare conventional sleep scoring with EEG power spectral analysis in assessing SDB's impact on sleep.
Main Methods:
- Overnight polysomnography in 90 children with SDB and 30 controls (ages 7-12).
- Sleep stages visually scored and EEG analyzed using power spectral analysis.
- Comparisons made across the whole night, by hour, and by sleep stage.
Main Results:
- Conventional scoring showed preserved sleep quality in slow-wave sleep (SWS) and REM sleep despite reduced total sleep time in severe SDB.
- EEG spectral power analysis revealed no substantial differences between SDB severity groups.
- Minor sleep disruptions were observed overall, irrespective of SDB severity, hour, or sleep stage.
Conclusions:
- Both methods indicate minimal sleep quality disruption in children with SDB.
- Daytime dysfunction in SDB may not be solely due to sleep disruption.
- Children's stronger sleep drive might preserve sleep quality even with severe SDB.
Study Objectives:
To identify the extent of sleep disruption in children with various severities of sleep disordered breathing (SDB) using both conventional visually scored assessment of sleep stages and arousal indices together with EEG power spectral analysis.
Design:
Sleep stages and power spectral analysis of the sleep EEG in children with varying severities of SDB with matched control subjects with no history of snoring were compared across the whole night, across sequential hours from sleep onset, and across sleep stages.
Measurements:
Overnight polysomnography was performed on 90 children (49M/41F) aged 7-12 y with SDB and 30 age-matched healthy controls (13M/17F). Sleep stages were visually scored and the EEG spectra were analyzed in 5-s epochs.
Results:
Conventional visual scoring indicated that, although sleep duration was reduced in severely affected children, sleep quality during the essential stages of SWS and REM was preserved, as evidenced by the lack of any significant decrease in their duration in SDB severity groups. This finding was supported by the lack of substantial differences in EEG spectral power between the groups over the whole night, within specific hours, and in individual sleep stages.
Conclusions:
Both conventional scoring and EEG spectral analysis indicated only minor disruptions to sleep quality in children with SDB when assessed across the night, in any specific hour of the night, or in any specific sleep stage. These results suggest that reduced daytime functioning previously reported in children with SDB may not be due to sleep disruption. We speculate that in children, in contrast to adults, a stronger sleep drive may preserve sleep quality even in severe SDB.
