Reduced NREM sleep instability in children with sleep disordered breathing.
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.
Kheirandish-Gozal
Leila
L
Division of Pediatric Sleep Medicine, Kosair Children's Hospital Research Institute, University of Louisville, Louisville, KY 40202, USA.
Miano
Silvia
S
Bruni
Oliviero
O
Ferri
Raffaele
R
Pagani
Jacopo
J
Villa
Maria Pia
MP
Gozal
David
D
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