Impaired Attention in Children with Obstructive Sleep Apnea: A Preliminary Study of Behavior Combined with
Yunxiao Wu1,2, Changming Wang3, Yingchao Jiang4
1School of Instrumentation Science and Optoelectronic Engineering, Beihang University, Beijing, 100191, People's Republic of China.
Insights
Children with moderate to severe obstructive sleep apnea (OSA) show attention deficits, evidenced by reduced N3 brainwave amplitude. This neurophysiological marker correlates with OSA severity, suggesting its utility in identifying cognitive impairment.
Area of Science:
- Neuroscience
- Pediatrics
- Sleep Medicine
Background:
- Obstructive sleep apnea (OSA) is common in children and can impact cognitive function.
- Attention deficits are a frequently reported consequence of OSA, but underlying neurophysiological mechanisms require further elucidation.
Purpose of the Study:
- To investigate attention network function in children with OSA using the Attention Network Test (ANT) combined with electroencephalography (EEG).
- To identify neurophysiological markers of attention impairment in children with varying degrees of OSA severity.
Main Methods:
- Eighty-seven children (aged 6-11 years) with suspected OSA underwent ANT testing with EEG and polysomnography.
- Participants were categorized into non-OSA, mild OSA, and moderate to severe (MS) OSA groups.
- Time-frequency analysis and event-related potential (ERP) analysis were performed on EEG data during ANT performance.
Main Results:
- Children with MS OSA exhibited reduced N3 component amplitude at the Fz electrode compared to non-OSA and mild OSA groups (P<0.05).
- The MS OSA group showed increased alpha band energy in the executive control network phase.
- Reduced N3 amplitude correlated with the obstructive apnea-hypopnea index (OAHI) (r=0.232, P=0.038).
Conclusions:
- Attention impairment in children with MS OSA is associated with reduced frontal N3 amplitude, a sensitive neurophysiological marker.
- Despite similar behavioral performance and questionnaire scores, distinct EEG alterations indicate subclinical cognitive deficits in OSA.
- N3 amplitude serves as a potential biomarker for OSA-related cognitive impairment in pediatric populations.
Objective:
To investigate how attention is affected in children with obstructive sleep apnea (OSA) using the attention network test (ANT) combined with event-related potential (ERP) and time-frequency analysis.
Methods:
Eighty-seven children aged 6-11 years with symptoms of snoring or mouth breathing during sleep were recruited from the Sleep Center of Beijing Children's Hospital from May to July, 2023. All participants completed the Mini-mental State Examination and Attention Deficit Hyperactivity Disorder rating scale. We acquired 32-lead electroencephalography (EEG) data while participants performed the ANT, followed by Polysomnography.
Results:
Of the 87 children, 21 had no OSA, 49 had mild OSA, and 17 had moderate to severe (MS) OSA. Each group had similar questionnaire scores, similar response time and accuracy for the different ANT conditions. There are alterations in the processing of three separate components of the attentional network in children with OSA. The amplitude of the N3 component at the FZ electrode in the MS OSA group was lower than that of the non-OSA and mild OSA groups (all P<0.05). In the executi control network phase, the energy of alpha band was higher in the MS OSA group than in the mild OSA group (Z=-2.624, P=0.026). The mean amplitude of the N3 component at the FZ electrode was correlated with the obstructive apnea-hypopnea index (OAHI) (r=0.232, P=0.038).
Conclusion:
Attention impairment was observed as a reduced N3 in the frontal area in the MS OSA group, which was correlated with the OAHI. However, questionnaire and behavioral performance did not differ significantly between groups. These findings suggest that the N3 amplitude is a sensitive neuroelectrophysiological marker of OSA-related cognitive impairment.
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