Attention in children with obstructive sleep apnoea: an event-related potentials study

Obstructive sleep apnoea (OSA) in children has been causally implicated in neurobehavioural and cognitive dysfunction. Consequently, the American Academy of Paediatrics highlighted the need to study pertinent functional cognitive outcomes before and after treatment. However, neurocognitive function has thus far only been assessed by caregiver-completed questionnaires, which can be labour intensive and time consuming, such that the need for complementary and more objective measures has emerged.

The study aimed to identify electrophysiological correlates of neurocognitive alterations in children with OSA and investigate utility as a predictive tool.

Twenty-eight children (14 OSA and 14 matched controls) underwent overnight sleep studies and neurocognitive testing, as well as the oddball attention task while event-related potentials (ERPs) were recorded. ERPs were analysed using temporal principal components and source analyses that provided dependent variables for the subsequent repeated measures analysis of variance (ANOVA) and multiple regressions. Time-locked waveforms formed spatial models that localised electrical activity in the brain. ERP differences between groups were then correlated to neurocognitive outcomes.

OSA children exhibited significantly altered ERP patterns of neural activation and impaired neurocognitive performance. Specific ERP variables exhibited accurate predictive ability regarding performance on neurobehavioural measures.

Specific ERP events during a single attention task can reliably identify the presence of OSA-associated cognitive dysfunction. Electrophysiological approaches during specific cognitive tasks may serve as simple, complementary, and reliable reporters of cognitive dysfunction associated with OSA in children.