Subcortical arousal response in child patients with obstructive sleep apnea.
OBJECTIVE
The objective of this study is to assess subcortical arousal response (SCA) in child patients with obstructive sleep apnea syndrome (OSAS).


METHODS
A new index termed SCA was defined as a sigh associated with elevated chin muscle activity. According to the duration, SCAs were divided into three types; SCA short (1s or more and less than 3s), SCA intermediate (3s or more and less than 10s), and SCA long (10s or more). We scored SCAs in six child OSAS patients, aged 2-5 years, before and after adenotonsillectomy. SCAs were also counted in four age-matched controls.


RESULTS
In the pretreatment records, 45.5% of SCAs were associated with electroencephalographic arousals. In all patients, SCA short and SCA intermediate decreased after the treatment to the levels in the controls. SCA long exhibited no consistent changes after treatment. The incidence of SCAs was much higher than arousals previously reported in child OSAS patients as well as in normal children.


CONCLUSIONS
SCAs, especially SCA short and SCA intermediate, are sensitive and useful indices for assessing subcortical involvement in child OSAS patients.
Department of Pediatrics, Tokyo Medical and Dental University, 1-5-45 Yushima, Tokyo 113-8519, Japan. jkohyama.ped@tmd.ac.jp
Jun
J
Kohyama
Takeshi
T
Hasegawa