Knarik Tamanyan1,2, Lisa M Walter1,2, Aidan Weichard1,2, Margot J Davey1,2,3, Gillian M Nixon1,2,3, Sarah N Biggs1,2, Rosemary S C Horne1,2. 1. 1 The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Victoria, Australia. 2. 2 Department of Paediatrics, Monash University, Melbourne, Victoria, Australia; and. 3. 3 Melbourne Children's Sleep Centre, Monash Children's Hospital, Melbourne, Victoria, Australia.
Abstract
RATIONALE: Childhood sleep-disordered breathing ranges in severity from primary snoring to obstructive sleep apnea and is associated with behavioral and neurocognitive deficits. It remains unknown why children with primary snoring, who do not experience peripheral oxygen desaturation or sleep fragmentation, experience similar daytime deficits as those with obstructive sleep apnea or why effects are age-dependent. OBJECTIVES: To examine cerebral tissue oxygenation and oxygen extraction as an explanation for daytime deficits in children with primary snoring. METHODS: Children referred for suspected sleep-disordered breathing and nonsnoring control subjects underwent overnight polysomnography with near-infrared spectroscopy. Children were categorized into 3- to 6-year (n = 87) and 7- to 12-year (n = 72) old groups, and according to the obstructive apnea-hypopnea index into primary snoring (≤1 event/h), mild (>1-5 events/h), and moderate/severe obstructive sleep apnea (>5 events/h). Cognitive and behavioral performance were assessed. MEASUREMENTS AND MAIN RESULTS: In the 3- to 6-year group, there were no differences in cerebral oxygenation or oxygen extraction between severity groups. In the 7- to 12-year group, cerebral oxygenation was significantly lower, although these differences were small, in control subjects versus primary snoring during quiet wakefulness before sleep onset, N1, and REM. Oxygen extraction was significantly higher in control subjects versus primary snoring during N1 sleep, with no differences between primary snoring and obstructive sleep apnea groups. Cerebral oxygenation was not associated with cognitive performance in either age group or behavior in the 3- to 6-year group; however, it was associated with behavior in the school-aged children. CONCLUSIONS: Children with sleep-disordered breathing are able to maintain cerebral oxygenation, and the small changes observed are not related to cognitive deficits. However, in older children these differences were related to behavioral measures.
RATIONALE: Childhood sleep-disordered breathing ranges in severity from primary snoring to obstructive sleep apnea and is associated with behavioral and neurocognitive deficits. It remains unknown why children with primary snoring, who do not experience peripheral oxygen desaturation or sleep fragmentation, experience similar daytime deficits as those with obstructive sleep apnea or why effects are age-dependent. OBJECTIVES: To examine cerebral tissue oxygenation and oxygen extraction as an explanation for daytime deficits in children with primary snoring. METHODS:Children referred for suspected sleep-disordered breathing and nonsnoring control subjects underwent overnight polysomnography with near-infrared spectroscopy. Children were categorized into 3- to 6-year (n = 87) and 7- to 12-year (n = 72) old groups, and according to the obstructive apnea-hypopnea index into primary snoring (≤1 event/h), mild (>1-5 events/h), and moderate/severe obstructive sleep apnea (>5 events/h). Cognitive and behavioral performance were assessed. MEASUREMENTS AND MAIN RESULTS: In the 3- to 6-year group, there were no differences in cerebral oxygenation or oxygen extraction between severity groups. In the 7- to 12-year group, cerebral oxygenation was significantly lower, although these differences were small, in control subjects versus primary snoring during quiet wakefulness before sleep onset, N1, and REM. Oxygen extraction was significantly higher in control subjects versus primary snoring during N1 sleep, with no differences between primary snoring and obstructive sleep apnea groups. Cerebral oxygenation was not associated with cognitive performance in either age group or behavior in the 3- to 6-year group; however, it was associated with behavior in the school-aged children. CONCLUSIONS:Children with sleep-disordered breathing are able to maintain cerebral oxygenation, and the small changes observed are not related to cognitive deficits. However, in older children these differences were related to behavioral measures.
Authors: Rosemary S C Horne; Ashwini Sakthiakumaran; Ahmad Bassam; Julie Thacker; Lisa M Walter; Margot J Davey; Gillian M Nixon Journal: Pediatr Res Date: 2020-11-23 Impact factor: 3.756
Authors: Phoebe K Yu; Jerilynn Radcliffe; H Gerry Taylor; Raouf S Amin; Cristina M Baldassari; Thomas Boswick; Ronald D Chervin; Lisa M Elden; Susan L Furth; Susan L Garetz; Alisha George; Stacey L Ishman; Erin M Kirkham; Christopher Liu; Ron B Mitchell; S Kamal Naqvi; Carol L Rosen; Kristie R Ross; Jay R Shah; Ignacio E Tapia; Lisa R Young; David A Zopf; Rui Wang; Susan Redline Journal: Sleep Date: 2022-02-12 Impact factor: 6.313
Authors: Lucia V Torres-Lopez; Cristina Cadenas-Sanchez; Jairo H Migueles; Irene Esteban-Cornejo; Pablo Molina-Garcia; Charles H Hillman; Andres Catena; Francisco B Ortega Journal: Eur J Pediatr Date: 2022-02-10 Impact factor: 3.183