0748 Relationship Between Neurobehavioral Function And Sleep Depth In Children With Obstructive Sleep Apnea. (27th April 2018)

• Record Type: Journal Article
• Authors: Tapia, I E; Kim, J; Radcliffe, J; Younes, M; Marcus, C L
• Is Part Of: Sleep. Volume 41(2018)Supplement 1
• Page Start: A278
• Page End: A278
• Publication Date: 2018-04-27
• Subjects: Sleep -- Physiological aspects -- Periodicals; Sleep disorders -- Periodicals; Sommeil -- Aspect physiologique -- Périodiques; Sommeil, Troubles du -- Périodiques; Sleep disorders; Sleep -- Physiological aspects; Sleep -- physiological aspects; Sleep Wake Disorders; Psychophysiology; Electronic journals; Periodicals; 616.8498
• DOI: 10.1093/sleep/zsy061.747
• Languages: English
• ISSNs: 0161-8105

Abstract

Abstract: Introduction: Children with the obstructive sleep apnea syndrome (OSAS) have neurobehavioral deficits during wakefulness, such as executive function and memory deficits, poor school performance, hyperactivity and inattention. However, no polysomnographic measure has been able to predict neurobehavioral outcomes, and the pathophysiology behind these is still unknown. The Odds-Ratio-Product (ORP) is a continuous index of sleep depth derived from the relation of powers in different EEG frequency bands to each other. It is highly correlated with arousability. We utilized the polysomnograms of children with OSAS in the "Childhood Adenotonsillectomy Trial" (CHAT) to determine if changes in neurobehavioral measures from baseline to follow up are correlated with changes in sleep depth. Methods: CHAT participants were randomized to early adenotonsillectomy (eAT) or watchful waiting (WW) and underwent polysomnography (PSG) and neurobehavioral testing at baseline and 7 months after randomization. Baseline and follow-up PSGs were analyzed to obtain ORP, spindle density, power and intrinsic frequency (involved in learning and memory), alpha intrusion (% of non-REM epochs with alpha power>30μV 2 ), and right-left EEG coherence. Changes in neurobehavioral measures between baseline and 7 months were regressed on changes in these sleep parameters and demographic variables using a stepwise model fitted and trimmed based on Akaike information criterion. When significant correlations were found we determined if the changes in the relevant variables were different between the eAT and WWSC groups. Here we present the relation between changes in sleep depth and neurobehavioral measures. Results: 383 participants (age=median[IQR] 6.75[5.75–8.0]) were studied. Executive functioning measured by the Behavior Rating Inventory of Executive Function and hyperactivity symptoms changes reported by Conners scale were positively associated with non-REM-ORP changes (p=0.007 and 0.028, respectively). Improvements in sleep depth and in these neurobehavioral tests were significantly greater in eAT group (p<0.001). Changes in Developmental Neuropsychological Assessment (NEPSY)-Word Generation Semantic Scaled Score and Inhibition Naming Combined Scale were not associated with non-REM-ORP changes. Conclusion: Improvements in executive function and hyperactivity symptoms in children with OSAS following adenotonsillectomy are in part related to sleep depth improvement. Support (If Any): K01HL130719 and UL1TR001878.