title: Sleep disturbance in pre-school children with obstructive sleep apnoea syndrome.
abstract: OBJECTIVE
  Sleep-disordered breathing in children is most prevalent in the pre-school years and has been associated with sleep fragmentation and hypoxia. We aimed to compare the sleep and spontaneous arousal characteristics of 3-5-year-old children with obstructive sleep apnoea (OSA) with that of non-snoring control children, and to further characterise the arousal responses to obstructive respiratory events.
  
  
  METHODS
  A total of 73 children (48 male) underwent overnight polysomnography: 51 for assessment of snoring who were subsequently diagnosed with OSA (obstructive apnoea hypopnoea index (OAHI)>1 event per h) and 22 control children recruited from the community (OAHI ≤ 1 and no history of snoring).
  
  
  RESULTS
  The OSA group had poorer sleep efficiency (p<0.05), spent a smaller proportion of their sleep period time in rapid eye movement (REM) (p<0.05), and had significantly fewer spontaneous arousals (p<0.001) compared with controls. One-quarter of the children with OSA had a sleep pressure score above the cut-off point for increased sleep pressure. In children with OSA, 62% of obstructive respiratory events terminated in a cortical arousal and 21% in a sub-cortical arousal. A significantly higher proportion of obstructive respiratory events terminated in a cortical arousal during non-REM (NREM) compared with REM (p<0.001).
  
  
  CONCLUSIONS
  These findings suggest that in pre-school children OSA has a profound effect on sleep and arousal patterns. Given that these children are at a critical period for brain development, the impact of OSA may have more severe consequences than in older children.
authors.affiliation: The Ritchie Centre, Monash Institute of Medical Research, Monash University, Melbourne, Victoria, Australia. lisa.walter@monash.edu
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Walter
authors.forename: Gillian M
authors.initials: GM
authors.lastname: Nixon
authors.forename: Margot J
authors.initials: MJ
authors.lastname: Davey
authors.forename: Denise M
authors.initials: DM
authors.lastname: O'Driscoll
authors.forename: John
authors.initials: J
authors.lastname: Trinder
authors.forename: Rosemary S C
authors.initials: RS
authors.lastname: Horne
mesh_terms: D001143:Arousal / Q000502:physiology; D002675:Child, Preschool; D005260:Female; D006801:Humans; D002534:Hypoxia, Brain / Q000453:epidemiology / Q000503:physiopathology; D008297:Male; D017286:Polysomnography; D015995:Prevalence; D012890:Sleep / Q000502:physiology; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology* / Q000503:physiopathology*; D020921:Sleep Arousal Disorders / Q000453:epidemiology* / Q000503:physiopathology*; D012892:Sleep Deprivation / Q000453:epidemiology* / Q000503:physiopathology*; D012895:Sleep, REM / Q000502:physiology; D012913:Snoring / Q000453:epidemiology / Q000503:physiopathology