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Urinary neurotransmitters are selectively altered in children with obstructive sleep apnea and predict cognitive

Leila Kheirandish-Gozal1, Corena J T McManus2, Gottfried H Kellermann2

  • 1Department of Pediatrics, Pritzker School of Medicine, The University of Chicago, Chicago, IL.

Chest
|January 12, 2013
PubMed

Insights

Pediatric obstructive sleep apnea (OSA) alters overnight urinary neurotransmitters, including epinephrine, norepinephrine, and GABA. These changes can help predict OSA and cognitive deficits in children.

Area of Science:

  • Pediatric Sleep Medicine
  • Neuroscience
  • Biochemistry

Background:

  • Pediatric obstructive sleep apnea (OSA) is linked to cognitive dysfunction.
  • Altered neurotransmitter function is suspected in pediatric OSA.
  • This study investigates overnight neurotransmitter changes in children with and without OSA.

Purpose of the Study:

  • To explore overnight changes in urinary neurotransmitters in children with and without OSA.
  • To determine if these neurotransmitter changes correlate with cognitive function.
  • To assess the potential of using neurotransmitter profiles to predict OSA and cognitive deficits.

Main Methods:

  • Collected urine samples from children with OSA and controls before and after sleep studies.
  • Administered a neurocognitive battery to assess general cognitive ability (GCA) in a subset of children with OSA.
  • Utilized enzyme-linked immunosorbent assays to measure 12 neurotransmitters, adjusting for creatinine concentrations.

Main Results:

  • Overnight increases in epinephrine, norepinephrine, and gamma-aminobutyric acid (GABA), and decreases in taurine were observed in children with OSA.
  • A combinatorial approach using these four neurotransmitters accurately predicted OSA (AUC: 0.923).
  • Alterations in GABA, taurine, and phenylethylamine levels differentiated children with OSA and low GCA from those with normal GCA (AUC: 0.977).

Conclusions:

  • Pediatric OSA is associated with increased urinary catecholamines, indicating heightened sympathetic activity.
  • Elevated GABA and reduced taurine levels may contribute to neuronal dysfunction in pediatric OSA.
  • Urinary neurotransmitter profiles show promise for predicting OSA and associated cognitive deficits in children.
Abstract

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