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Cyclic alternating pattern in infants with congenital hypothyroidism.
Rafael Santana-Miranda1, Chiharu Murata2, Oliveiro Bruni3
1Sleep Disorders Clinic, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico.
Brain & Development
|July 25, 2018
Summary
Congenital hypothyroidism in infants is linked to altered sleep patterns, specifically reduced electroencephalographic synchrony (A1 subtype) and increased desynchrony (A3 subtype). These sleep changes may indicate developmental differences in affected infants.
Area of Science:
- Pediatric Neurology
- Sleep Medicine
- Endocrinology
Background:
- Congenital hypothyroidism (CH) is a critical condition affecting brain development due to thyroid hormone deficiency at birth.
- Cyclic Alternating Pattern (CAP) in non-Rapid eye movement sleep is increasingly recognized for its role in pediatric brain development and cognition.
- Previous research suggests a link between CAP and neurodevelopmental outcomes in various pediatric conditions.
Purpose of the Study:
- To investigate and compare the Cyclic Alternating Pattern (CAP) characteristics in infants with congenital hypothyroidism (CH) and healthy controls.
- To evaluate the relationship between CAP parameters, sleep disturbances, and age in infants with and without CH.
- To determine if CAP metrics can serve as indicators of sleep development in infants with CH.
Main Methods:
- Polysomnography recordings were conducted on 19 healthy infants and 21 infants diagnosed with CH.
- Cyclic Alternating Pattern (CAP) parameters, including phase A subtypes (A1, A2, A3), were analyzed during non-Rapid eye movement sleep.
- Sleep data were collected following the International 10-20 System, with analysis focusing on electroencephalographic synchrony and desynchrony.
Main Results:
- Infants with CH exhibited a higher frequency of central apnea, hypopnea, and arousals compared to controls.
- CH infants showed a significantly higher percentage of A3 subtype (electroencephalographic desynchrony) and a lower percentage of A1 subtype (electroencephalographic synchrony).
- A positive correlation between A1 mean duration and age was observed, but this effect was diminished in the CH group.
Conclusions:
- Infants with congenital hypothyroidism display distinct sleep abnormalities, including increased central apneas and arousals, alongside altered CAP patterns.
- A reduction in the percentage and mean duration of the A1 subtype (synchrony) may serve as a valuable indicator of impaired sleep development in infants with CH.
- These findings highlight the importance of sleep monitoring in CH management and underscore the potential of CAP analysis for assessing neurodevelopmental trajectories.
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