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Updated: Jul 2, 2025

Event Related Potentials ERPs and other EEG Based Methods for Extracting Biomarkers of Brain Dysfunction: Examples from Pediatric Attention Deficit/Hyperactivity Disorder ADHD
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Event Related Potentials ERPs and other EEG Based Methods for Extracting Biomarkers of Brain Dysfunction: Examples from Pediatric Attention Deficit/Hyperactivity Disorder ADHD

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Characteristics of ADHD Symptoms and EEG Theta/Beta Ratio in Children With Sleep Disordered Breathing

Dandi Ma1, Yunxiao Wu2, Changming Wang3

  • 1Department of Respiratory Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.

Clinical EEG and Neuroscience
|February 26, 2024
PubMed

Insights

Children with sleep disordered breathing (SDB) exhibit more attention deficit-hyperactivity disorder (ADHD) symptoms. The study found a link between hypoxia, theta/beta ratio (TBR), and ADHD symptom severity in children with SDB.

Area of Science:

  • Pediatric Neurology
  • Sleep Medicine
  • Neurophysiology

Background:

  • Sleep disordered breathing (SDB) is prevalent in children and may impact neurodevelopment.
  • Attention deficit-hyperactivity disorder (ADHD) symptoms are common in children with SDB.
  • The theta/beta ratio (TBR) on electroencephalogram (EEG) is a potential biomarker for cognitive function.

Purpose of the Study:

  • To investigate parent-reported ADHD symptoms in children with SDB.
  • To analyze sleep EEG theta/beta ratio (TBR) characteristics in children with SDB.
  • To explore the relationship between SDB severity, TBR, and ADHD symptoms.

Main Methods:

  • Cross-sectional study comparing children with SDB (n=103) and healthy controls (n=28).
  • Parental SNAP-IV questionnaire for ADHD symptoms.
  • Overnight polysomnography and EEG analysis of TBR during non-rapid eye movement (NREM) sleep.

Main Results:

  • Children with SDB demonstrated significantly worse ADHD symptoms than controls.
  • No overall intergroup difference in TBR was found, but a significant main effect for NREM period was observed.
  • Hypoxia (low oxygen saturation) was negatively associated with hyperactivity/impulsivity, and TBR during NREM sleep was positively correlated with inattention.

Conclusions:

  • Children with SDB exhibit increased inattentive ADHD symptoms.
  • TBR may reflect nocturnal electrophysiological changes in children with SDB.
  • The findings suggest a relationship between hypoxia, TBR, and daytime ADHD symptoms in children with SDB.

Keywords:
ADHDchildrensleep disordered breathingsleep electroencephalographytheta/beta ratio

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