Age Effects on Cerebral Oxygenation and Behavior in Children with Sleep Disordered Breathing.

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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.

OBJECTIVE

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 non-snoring controls underwent overnight polysomnography with Near Infrared Spectroscopy. Children were categorized into 3-6y (N=87) and 7-12y (N=72) 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 3-6y, there were no differences in cerebral oxygenation or oxygen extraction between severity groups. In 7-12y, cerebral oxygenation was significantly lower in controls versus primary snoring during Wake, N1 and REM. Oxygen extraction was significantly higher in controls 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 3-6y; 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.

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