Correlates of respiratory cycle-related EEG changes in children with sleep-disordered breathing.
OBJECTIVE
To explore newly-identified respiratory cycle-related electroencephalographic changes (RCREC), which may represent microarousals, as correlates of neurobehavioral outcomes in children with sleep-disordered breathing (SDB).


METHODS
Retrospective.


METHODS
University sleep laboratory.


METHODS
Ten research subjects, aged 6 to 10 years, with and without SDB.


METHODS
Polysomnography, Multiple Sleep Latency Tests, and tests of auditory attention before and after clinically-indicated tonsillectomy (n = 9) or hernia repair (n = 1, control).


METHODS
For the first 3 hours of nocturnal sleep, a computer algorithm quantified the degree to which delta, theta, and alpha electroencephalographic power varied within non-apneic respiratory cycles. Correlations between the RCREC and standard objective measures of SDB, sleepiness, and attention were explored.


RESULTS
Five children had SDB (> 1 obstructive apnea per hour of sleep). Preoperative delta, theta, or alpha RCREC were statistically significant (P < .01) in all subjects except 1 without SDB and the 1 control. Theta RCREC correlated with rates of apneas and hypopneas (P = .01) and decreased after the apnea was treated. Postoperative changes in delta and theta RCREC predicted changes in Multiple Sleep Latency Test scores (rho = -0.84, P = .002; rho = -0.64, P = .05), whereas changes in rates of apneas and hypopneas did not (rho = -0.24, P = .50). Postoperative changes in attention tended to correlate with changes in delta RCREC (rho = -0.54, P = .11) more strongly than with changes in rates of apneic events (rho = -0.07, P = .84).


CONCLUSIONS
The RCREC may reflect brief but numerous microarousals that could help to explain neurobehavioral consequences of SDB.
Sleep Disorders Center and Department of Neurology, University of Michigan, Ann Arbor, Mich, USA. chervin@umich.edu
Ronald D
RD
Chervin
Joseph W
JW
Burns
Nikolas S
NS
Subotic
Christopher
C
Roussi
Brian
B
Thelen
Deborah L
DL
Ruzicka
D000465:Algorithms; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008297:Male; D010507:Periodicity; D011182:Postoperative Care; D011300:Preoperative Care; D012119:Respiration; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000175:diagnosis* / Q000209:etiology; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000175:diagnosis