title: Reduced NREM sleep instability in children with sleep disordered breathing.
abstract: OBJECTIVE
  To evaluate NREM sleep instability, as measured by the cyclic alternating pattern (CAP), in a cohort of children with mild sleep disordered breathing (SDB) or frank obstructive sleep apnea (OSA) and normal controls.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Sleep laboratory in academic center.
  
  
  METHODS
  Twenty-two patients (13 boys; mean age 6.5 +/- 2.4 years; 10 with mild SDB and 12 with OSA) and 15 normal children matched for age underwent overnight polysomnographic recordings in a standard laboratory setting. Sleep was visually scored for sleep macrostructure and CAP in a blinded fashion using standard criteria. Markovian analysis was also performed.
  
  
  RESULTS
  Participants with OSA had reduced total CAP rates than normal controls and mild SDB patients. Children with mild SDB or OSA had a lower number of A1, lower A1 percentage, and lower A1 index than controls. Children with OSA also showed longer intervals between consecutive A phases and a decrease in entropy in the Markovian analysis.
  
  
  CONCLUSIONS
  The lower CAP rate and its reduced entropy in children with mild SDB or OSA seem to indicate the presence of subtle sleep alterations that are not clearly identifiable with other approaches and might provide more robust correlates of neurocognitive and behavioral dysfunction in snoring children.
authors.affiliation: Division of Pediatric Sleep Medicine, Kosair Children's Hospital Research Institute, University of Louisville, Louisville, KY 40202, USA.
authors.forename: Leila
authors.initials: L
authors.lastname: Kheirandish-Gozal
authors.forename: Silvia
authors.initials: S
authors.lastname: Miano
authors.forename: Oliviero
authors.initials: O
authors.lastname: Bruni
authors.forename: Raffaele
authors.initials: R
authors.lastname: Ferri
authors.forename: Jacopo
authors.initials: J
authors.lastname: Pagani
authors.forename: Maria Pia
authors.initials: MP
authors.lastname: Villa
authors.forename: David
authors.initials: D
authors.lastname: Gozal
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008390:Markov Chains; D017286:Polysomnography; D011446:Prospective Studies; D012016:Reference Values; D012890:Sleep / Q000502:physiology*; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000503:physiopathology; D012894:Sleep Stages / Q000502:physiology; D012913:Snoring / Q000503:physiopathology