Investigation of macro and micro sleep structures of first night effect in school-aged children

Area of Science:

• Pediatric Sleep Medicine
• Neuroscience
• Developmental Psychology

Background:

• The first night effect (FNE) is a phenomenon where sleep quality and architecture are altered on the first night of polysomnography (PSG) recording compared to subsequent nights.
• While FNE is well-documented in adults, its occurrence and age-related modifications in school-age children require further investigation.
• Understanding FNE in pediatric populations is essential for accurate interpretation of sleep studies.

Purpose of the Study:

• To investigate the presence and age-specific alterations of the first night effect (FNE) in school-age children.
• To analyze both macro (sleep architecture) and micro (frequency analysis) sleep parameters affected by FNE.
• To examine the relationship between chronological age and FNE-related changes in sleep variables and spectral power.

Main Methods:

• Acquisition of polysomnography (PSG) data from 38 healthy children aged 6-15 years over two consecutive nights.
• Comparison of key sleep variables (e.g., total sleep time, sleep efficiency, sleep stages) and spectral power analysis between the first and second nights.
• Correlation analysis to assess the relationship between age and the magnitude of FNE-induced changes.

Main Results:

• Significant FNE-related reductions in total sleep time, sleep efficiency, N1, N2, and REM sleep, alongside increases in sleep onset latency and wake after sleep onset were observed.
• The decrease in N3 sleep and increase in N2 sleep due to FNE showed a positive and negative correlation with age, respectively.
• Spectral analysis revealed no significant FNE effect for most variables, but a trend towards increased delta band convergence with age was noted.

Conclusions:

• The first night effect (FNE) is present in school-age children and exhibits age-dependent characteristics.
• Age influences the manifestation of FNE, with decreases in N3 and increases in N2 becoming more pronounced in older children.
• Low-frequency power enhancement during FNE appears consistent across different ages, suggesting a stable physiological response.
• These findings emphasize the need to consider age-specific sleep patterns and utilize multi-level analytical approaches for accurate pediatric PSG interpretation.