Slow wave activity and executive dysfunction in children with sleep disordered breathing

Purpose: This study aimed to examine slow wave activity (SWA), a marker of homeostatic regulation, as a potential mechanism linking sleep disordered breathing (SDB) with executive dysfunction in children. Methods: Executive function domains of working memory, spatial planning, information processing, and sustained attention were assessed using the Cambridge Neuropsychological Test Automated Battery (CANTAB) in children (N = 40; 5–12 years) referred for clinical diagnosis of SDB. Polysomnography records of non-snoring, age-matched controls (N = 34) were retrospectively examined for comparison of SWA. Power spectral analysis of the delta wave determined SWA. Group differences in sleep, respiratory, and SWA outcomes were examined. Mean CANTAB scores were compared to standardized norms and correlated against SWA. Results: Children with SDB showed increased SWA compared to non-snoring controls and scored < 25th percentile for planning accuracy, speed of mental processing, and task efficiency, when compared against population norms. Increasing severity of SDB was associated with an increased difficulty in solving complex tasks and time on task performance. SWA was associated with performance on tasks of early problem solving and efficiency during sustained attention. Conclusions: SWA, a subtle measure of sleep disruption and sleep regulation, is associated with deficits in problem solving and sustained attention in children with SDB. As current mechanistic theories do not account for deficits observed in children with mild forms of SDB, this study provides a promising alternative.