Age effects on cerebral oxygenation and behavior in children with sleep-disordered breathing

Knarik Tamanyan, Lisa M. Walter, Aidan Weichard, Margot J. Davey, Gillian M. Nixon, Sarah N. Biggs, Rosemary S.C. Horne

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Rationale: Childhood sleep-disordered breathing ranges in severity from primary snoring to obstructive sleep apnea and is associated with behavioral and neurocognitive deficits. It remains unknown why children with primary snoring, who do not experience peripheral oxygen desaturation or sleep fragmentation, experience similar daytime deficits as those with obstructive sleep apnea or why effects are age-dependent. Objectives: To examine cerebral tissue oxygenation and oxygen extraction as an explanation for daytime deficits in children with primary snoring. Methods: Children referred for suspected sleep-disordered breathing and nonsnoring control subjects underwent overnight polysomnography with near-infrared spectroscopy. Children were categorized into 3- to 6-year (n = 87) and 7- to 12-year (n = 72) old groups, and according to the obstructive apnea-hypopnea index into primary snoring (<1 event/h), mild (.1-5 events/h), and moderate/severe obstructive sleep apnea (.5 events/h). Cognitive and behavioral performance were assessed. Measurements and Main Results: In the 3- to 6-year group, there were no differences in cerebral oxygenation or oxygen extraction between severity groups. In the 7- to 12-year group, cerebral oxygenation was significantly lower, although these differences were small, in control subjects versus primary snoring during quiet wakefulness before sleep onset, N1, and REM. Oxygen extraction was significantly higher in control subjects versus primary snoring during N1 sleep, with no differences between primary snoring and obstructive sleep apnea groups. Cerebral oxygenation was not associated with cognitive performance in either age group or behavior in the 3- to 6-year group; however, it was associated with behavior in the school-aged children. Conclusions: Children with sleep-disordered breathing are able to maintain cerebral oxygenation, and the small changes observed are not related to cognitive deficits. However, in older children these differences were related to behavioral measures.

Original languageEnglish
Pages (from-to)1468-1477
Number of pages10
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume197
Issue number11
DOIs
Publication statusPublished - 1 Jun 2018

Keywords

  • Behavior
  • Cognition
  • Near-infrared spectroscopy
  • Pediatric sleep

Cite this

@article{e5d357106c2b40be97eb963514dd3ec3,
title = "Age effects on cerebral oxygenation and behavior in children with sleep-disordered breathing",
abstract = "Rationale: Childhood sleep-disordered breathing ranges in severity from primary snoring to obstructive sleep apnea and is associated with behavioral and neurocognitive deficits. It remains unknown why children with primary snoring, who do not experience peripheral oxygen desaturation or sleep fragmentation, experience similar daytime deficits as those with obstructive sleep apnea or why effects are age-dependent. Objectives: To examine cerebral tissue oxygenation and oxygen extraction as an explanation for daytime deficits in children with primary snoring. Methods: Children referred for suspected sleep-disordered breathing and nonsnoring control subjects underwent overnight polysomnography with near-infrared spectroscopy. Children were categorized into 3- to 6-year (n = 87) and 7- to 12-year (n = 72) old groups, and according to the obstructive apnea-hypopnea index into primary snoring (<1 event/h), mild (.1-5 events/h), and moderate/severe obstructive sleep apnea (.5 events/h). Cognitive and behavioral performance were assessed. Measurements and Main Results: In the 3- to 6-year group, there were no differences in cerebral oxygenation or oxygen extraction between severity groups. In the 7- to 12-year group, cerebral oxygenation was significantly lower, although these differences were small, in control subjects versus primary snoring during quiet wakefulness before sleep onset, N1, and REM. Oxygen extraction was significantly higher in control subjects versus primary snoring during N1 sleep, with no differences between primary snoring and obstructive sleep apnea groups. Cerebral oxygenation was not associated with cognitive performance in either age group or behavior in the 3- to 6-year group; however, it was associated with behavior in the school-aged children. Conclusions: Children with sleep-disordered breathing are able to maintain cerebral oxygenation, and the small changes observed are not related to cognitive deficits. However, in older children these differences were related to behavioral measures.",
keywords = "Behavior, Cognition, Near-infrared spectroscopy, Pediatric sleep",
author = "Knarik Tamanyan and Walter, {Lisa M.} and Aidan Weichard and Davey, {Margot J.} and Nixon, {Gillian M.} and Biggs, {Sarah N.} and Horne, {Rosemary S.C.}",
year = "2018",
month = "6",
day = "1",
doi = "10.1164/rccm.201709-1825OC",
language = "English",
volume = "197",
pages = "1468--1477",
journal = "American Journal of Respiratory and Critical Care Medicine",
issn = "1073-449X",
publisher = "American Thoracic Society",
number = "11",

}

Age effects on cerebral oxygenation and behavior in children with sleep-disordered breathing. / Tamanyan, Knarik; Walter, Lisa M.; Weichard, Aidan; Davey, Margot J.; Nixon, Gillian M.; Biggs, Sarah N.; Horne, Rosemary S.C.

In: American Journal of Respiratory and Critical Care Medicine, Vol. 197, No. 11, 01.06.2018, p. 1468-1477.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Age effects on cerebral oxygenation and behavior in children with sleep-disordered breathing

AU - Tamanyan, Knarik

AU - Walter, Lisa M.

AU - Weichard, Aidan

AU - Davey, Margot J.

AU - Nixon, Gillian M.

AU - Biggs, Sarah N.

AU - Horne, Rosemary S.C.

PY - 2018/6/1

Y1 - 2018/6/1

N2 - Rationale: Childhood sleep-disordered breathing ranges in severity from primary snoring to obstructive sleep apnea and is associated with behavioral and neurocognitive deficits. It remains unknown why children with primary snoring, who do not experience peripheral oxygen desaturation or sleep fragmentation, experience similar daytime deficits as those with obstructive sleep apnea or why effects are age-dependent. Objectives: To examine cerebral tissue oxygenation and oxygen extraction as an explanation for daytime deficits in children with primary snoring. Methods: Children referred for suspected sleep-disordered breathing and nonsnoring control subjects underwent overnight polysomnography with near-infrared spectroscopy. Children were categorized into 3- to 6-year (n = 87) and 7- to 12-year (n = 72) old groups, and according to the obstructive apnea-hypopnea index into primary snoring (<1 event/h), mild (.1-5 events/h), and moderate/severe obstructive sleep apnea (.5 events/h). Cognitive and behavioral performance were assessed. Measurements and Main Results: In the 3- to 6-year group, there were no differences in cerebral oxygenation or oxygen extraction between severity groups. In the 7- to 12-year group, cerebral oxygenation was significantly lower, although these differences were small, in control subjects versus primary snoring during quiet wakefulness before sleep onset, N1, and REM. Oxygen extraction was significantly higher in control subjects versus primary snoring during N1 sleep, with no differences between primary snoring and obstructive sleep apnea groups. Cerebral oxygenation was not associated with cognitive performance in either age group or behavior in the 3- to 6-year group; however, it was associated with behavior in the school-aged children. Conclusions: Children with sleep-disordered breathing are able to maintain cerebral oxygenation, and the small changes observed are not related to cognitive deficits. However, in older children these differences were related to behavioral measures.

AB - Rationale: Childhood sleep-disordered breathing ranges in severity from primary snoring to obstructive sleep apnea and is associated with behavioral and neurocognitive deficits. It remains unknown why children with primary snoring, who do not experience peripheral oxygen desaturation or sleep fragmentation, experience similar daytime deficits as those with obstructive sleep apnea or why effects are age-dependent. Objectives: To examine cerebral tissue oxygenation and oxygen extraction as an explanation for daytime deficits in children with primary snoring. Methods: Children referred for suspected sleep-disordered breathing and nonsnoring control subjects underwent overnight polysomnography with near-infrared spectroscopy. Children were categorized into 3- to 6-year (n = 87) and 7- to 12-year (n = 72) old groups, and according to the obstructive apnea-hypopnea index into primary snoring (<1 event/h), mild (.1-5 events/h), and moderate/severe obstructive sleep apnea (.5 events/h). Cognitive and behavioral performance were assessed. Measurements and Main Results: In the 3- to 6-year group, there were no differences in cerebral oxygenation or oxygen extraction between severity groups. In the 7- to 12-year group, cerebral oxygenation was significantly lower, although these differences were small, in control subjects versus primary snoring during quiet wakefulness before sleep onset, N1, and REM. Oxygen extraction was significantly higher in control subjects versus primary snoring during N1 sleep, with no differences between primary snoring and obstructive sleep apnea groups. Cerebral oxygenation was not associated with cognitive performance in either age group or behavior in the 3- to 6-year group; however, it was associated with behavior in the school-aged children. Conclusions: Children with sleep-disordered breathing are able to maintain cerebral oxygenation, and the small changes observed are not related to cognitive deficits. However, in older children these differences were related to behavioral measures.

KW - Behavior

KW - Cognition

KW - Near-infrared spectroscopy

KW - Pediatric sleep

UR - http://www.scopus.com/inward/record.url?scp=85048105952&partnerID=8YFLogxK

U2 - 10.1164/rccm.201709-1825OC

DO - 10.1164/rccm.201709-1825OC

M3 - Article

VL - 197

SP - 1468

EP - 1477

JO - American Journal of Respiratory and Critical Care Medicine

JF - American Journal of Respiratory and Critical Care Medicine

SN - 1073-449X

IS - 11

ER -