Neurocognitive and endothelial dysfunction in children with obstructive sleep apnea
David Gozal1, Leila Kheirandish-Gozal, Rakesh Bhattacharjee
1Department of Pediatrics, University of Chicago, 5721 S Maryland Ave, MC 8000, Suite K-160, Chicago, IL 60637, USA. dgozal@uchicago.edu
Pediatrics
|October 20, 2010
Summary
Pediatric obstructive sleep apnea syndrome (OSAS) is linked to neurocognitive deficits and endothelial dysfunction. These conditions often coexist in children, suggesting shared underlying causes and the potential for early detection using vascular response tests.
Area of Science:
- Pediatric Sleep Medicine
- Neuroscience
- Cardiovascular Physiology
Background:
- Pediatric obstructive sleep apnea syndrome (OSAS) is associated with significant neurocognitive and endothelial dysfunction.
- The relationship and potential shared pathophysiology between these two common OSAS morbidities in children remain unclear.
Purpose of the Study:
- To concurrently assess neurocognitive deficits and endothelial function in children with OSAS.
- To investigate whether these morbidities share common pathophysiological mechanisms.
Main Methods:
- Children aged 5-8 years with polysomnographically confirmed OSAS underwent cognitive testing and cuff-occlusion hyperemic tests for endothelial function assessment.
- Neurocognitive deficits (NC(+)) were defined by ≥ 2 abnormal cognitive tests; endothelial dysfunction (ED(+)) by a post-hyperemic response time (Tmax) ≥ 45 seconds.
Main Results:
- In children with OSAS, 48 were NC(+) and 50 had ED(+); over 80% overlapped between these groups.
- Conversely, only 25.6% of children without neurocognitive deficits had ED(+), and 21.6% without ED(+) had neurocognitive deficits.
- Approximately one-third of children with OSAS had neither neurocognitive deficits nor endothelial dysfunction, indicating a strong association between the two.
Conclusions:
- Endothelial dysfunction and neurocognitive deficits frequently coexist in pediatric OSAS, more than expected by chance.
- These findings suggest shared pathogenetic mechanisms for both morbidities in pediatric OSAS.
- Post-hyperemic vascular response tests may aid in identifying children at risk for neuropsychological deficits.
More Related Videos
07:54Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
08:35Oxygenation-sensitive Cardiac MRI with Vasoactive Breathing Maneuvers for the Non-invasive Assessment of Coronary Microvascular Dysfunction
Published on: August 17, 2022
Related Concept Videos
01:21Sleep Apnea
Sleep apnea is a condition where breathing stops intermittently during sleep, often leading to significant health issues. Each episode can last from 10 to 20 seconds or more and is frequently accompanied by a brief arousal from sleep. This disturbance, largely unnoticed by the individual, can lead to severe daytime fatigue. Commonly, individuals seek help after being informed by their partners about loud snoring and noticeable breathing pauses during sleep.
The condition is more prevalent among...
The condition is more prevalent among...
01:13Insufficient Sleep and Sleep Deprivation
Insufficient sleep refers to not getting the recommended amount of sleep for optimal functioning, even if it's just slightly less than needed. Sleep insufficiency may occur due to lifestyle choices, such as staying up late for social events or work, resulting in routinely getting less sleep than required. For example, consistently sleeping 6 hours when the body needs 7-9 hours can lead to cumulative effects on health and well-being.
Sleep deprivation is a more severe form of sleep loss...
Sleep deprivation is a more severe form of sleep loss...
01:24Sleep-Wake Cycles
Sleep is an essential physiological process vital to maintaining overall well-being. The reticular activating system (RAS), a network of neurons in the brainstem, regulates wakefulness and sleep. While it may seem passive, sleep consists of distinct cycles, each with its unique characteristics and functions. Two key sleep phases are non-rapid eye movement (NREM) and rapid eye movement (REM).
NREM Sleep
NREM sleep comprises four progressive stages that seamlessly merge:
NREM Sleep
NREM sleep comprises four progressive stages that seamlessly merge:
01:30Attention-Deficit/Hyperactivity Disorder
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by persistent inattention, hyperactivity, and impulsivity. It affects approximately 5-8% of children globally, with around 60-70% of cases persisting into adulthood. ADHD has significant implications for educational attainment, social interactions, and occupational success.
Diagnostic Criteria and Symptoms
To diagnose ADHD, symptoms must manifest before age 12 and be evident across multiple settings.
Diagnostic Criteria and Symptoms
To diagnose ADHD, symptoms must manifest before age 12 and be evident across multiple settings.
01:24Substance Use Disorders Affecting Sleep
Substance use disorders involve a pattern of using drugs more extensively than intended and continuing use despite harmful consequences. This includes legal substances like alcohol and nicotine, as well as illegal drugs. These disorders often involve both physical and psychological dependence, reflecting compulsive use of substances that significantly alter thoughts, feelings, and behaviors, contributing to a major public health issue.
Understanding the concepts of physical dependence,...
Understanding the concepts of physical dependence,...