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How to Obtain Reliable Visual Event-related Potentials in Newborns
Published on: October 24, 2019
EEG spectral analysis of apnoeic events confirms visual scoring in childhood sleep disordered breathing
Joel S C Yang1, Christian L Nicholas, Gillian M Nixon
1The Ritchie Centre, Monash Institute of Medical Research, Monash University, Level 5, Monash Medical Centre, 246 Clayton Rd, Clayton, Melbourne, Victoria, Australia.
Insights
Electroencephalogram (EEG) spectral analysis confirms clinical scoring of arousals in children with obstructive sleep apnoea (OSA). This validates current methods for identifying cortical arousals at respiratory event termination.
Area of Science:
- Pediatric Sleep Medicine
- Neurophysiology
- Respiratory Medicine
Background:
- Obstructive sleep apnoea (OSA) in children is associated with sleep disturbances, including arousals.
- Accurate identification of arousals is crucial for clinical classification and management.
- Standard visual scoring of electroencephalogram (EEG) is the current method for arousal detection.
Purpose of the Study:
- To compare EEG spectral analysis with standard visual scoring for arousal classification.
- To assess the validity of clinical arousal scoring at respiratory event termination in pediatric OSA.
- To determine if EEG spectral analysis can detect micro-arousals not identified by visual scoring.
Main Methods:
- Twenty children (aged 7-12 years) with moderate to severe OSA underwent polysomnography.
- EEG data were spectrally analyzed in epochs surrounding respiratory events.
- EEG spectral power was compared between visually classified cortical arousals, subcortical activations, and non-arousals.
Main Results:
- No significant differences in EEG power spectra were observed between REM and NREM sleep.
- A statistically significant decrease in delta and theta spectral power was found at respiratory event terminations associated with cortical arousals.
- No significant changes in EEG power were detected for subcortical activations or non-arousals.
Conclusions:
- The findings support the validity of clinical arousal classifications at respiratory event termination.
- The absence of significant EEG spectral power changes in non-arousal events suggests no undetected micro-arousals.
- EEG spectral analysis can be a valuable tool to complement visual scoring in pediatric OSA research.
Purpose:
This study compared electroencephalogram (EEG) spectral analysis with standard visual scoring to assess the validity of clinical classification of arousals at respiratory event termination in children with obstructive sleep apnoea (OSA).
Methods:
Twenty children (six M/14 F) aged 7-12 years, diagnosed with moderate to severe OSA participated in this study. Overnight polysomnography was performed, and sleep stages and arousals visually scored using clinical paediatric measures. The EEG was spectrally analysed in six 5-s epochs across respiratory events, namely two consecutive 5-s epochs pre-event onset and a 5s epoch post-event onset, 5-s before event termination, and two contiguous 5-s epochs post-event termination. EEG spectral power distribution was compared across respiratory events visually categorised as full cortical arousals, subcortical activations, or non-arousals using specialised software (Sleep Research System 5.0).
Results:
There was no difference in power spectra between events in REM and NREM sleep and these were combined. There was a statistically significant fall from pre-arousal baseline values in delta and theta spectral power at respiratory event terminations associated with cortical arousals only. No change in power was detected at respiratory event terminations associated with subcortical activations or non-arousals.
Conclusions:
The lack of significant EEG spectral power changes at respiratory event terminations not associated with visually identified cortical arousals indicates undetected micro-arousals are not present. The results support the validity of clinical classifications of arousals at respiratory event termination.
