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 Nichole; Horne, Rosemary Sylvia Claire

doi:10.1164/rccm.201709-1825oc

Cited by 31 publications

(17 citation statements)

References 38 publications

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“…Cerebral autoregulation is reduced in adults with OSA (Nasr et al 2009). Similar studies investigating autoregulation of cerebral oxygenation in children with OSA have not been conducted, although our previous study reported that children with all severities of SDB tended to have higher, although not significant, TOI in comparison to healthy controls (Tamanyan et al 2018). In contrast, Khadra et al (2008) reported children with SDB tended to have lower TOI compared with controls.…”

Section: Discussionmentioning

confidence: 70%

“…Similar studies investigating autoregulation of cerebral oxygenation in children with OSA have not been conducted, although our previous study reported that children with all severities of SDB tended to have higher, although not significant, TOI in comparison to healthy controls (Tamanyan et al . ). In contrast, Khadra et al .…”

Section: Discussionmentioning

confidence: 97%

“…; Tamanyan et al . ). It is possible that the repetitive bradycardia and tachycardia which occur during and following respiratory events, respectively, are accompanied by repetitive changes in cerebral oxygenation.…”

Section: Introductionmentioning

confidence: 97%

“…Furthermore, adult studies have demonstrated decreased cerebral oxygenation in patients with OSA compared with controls (Hayakawa et al 1996;Valipour et al 2002;Schwarz et al 2018). There have been only three studies assessing cerebral oxygenation in children with SDB and although they identified that changes in brain oxygenation are seen in relation to obstructive events without changes in peripheral oxygenation, only small differences in cerebral oxygenation were found between children with SDB and non-snoring control children when averaged across the sleep stages (Khadra et al 2008;Olmo Arroyo et al 2017;Tamanyan et al 2018). It is possible that the repetitive bradycardia and tachycardia which occur during and following respiratory events, respectively, are accompanied by repetitive changes in cerebral oxygenation.…”

Section: Introductionmentioning

confidence: 99%

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Sleep disordered breathing in children disrupts the maturation of autonomic control of heart rate and its association with cerebral oxygenation

Walter

Tamanyan

Weichard

et al. 2018

The Journal of Physiology

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Key points Sleep disordered breathing (SDB) affects 4–11% of children and is associated with adverse neurocognitive, behavioural and cardiovascular outcomes, including reduced autonomic control. The relationship between heart rate variability (HRV; a measure of autonomic control) and age found in non‐snoring control children was absent during sleep in children with SDB. Age significantly predicted increasing cerebral oxygenation during wake in non‐snoring control children, whereas during sleep, HRV significantly predicted decreasing cerebral oxygenation. Cerebral oxygenation was not associated with either age or HRV in children with SDB during both wake and sleep. SDB significantly disrupts the normal maturation of autonomic control and the positive association between autonomic control and cerebral oxygenation found in non‐snoring children, and we speculate that the dampened autonomic control exhibited by children with SDB may have an attenuating effect on cerebral autoregulation via the moderating influence of HRV on cerebral blood flow. Abstract The repetitive episodes of hypoxia that are features of sleep disordered breathing (SDB) in children are associated with alterations in autonomic control of heart rate in an age‐dependent manner. We aimed to relate heart rate variability (HRV) parameters to age and measures of cerebral oxygenation in children (3–12 years old) with SDB and non‐snoring controls. Children (SDB, n = 117; controls, n = 42; 3–12 years) underwent overnight polysomnography. Total (TP), low‐ (LF) and high‐frequency (HF) power, tissue oxygenation index (TOI) and fractional tissue oxygen extraction (FTOE) were analysed during wake and sleep. Pearson's correlations determined the association between age and HRV parameters, and multiple linear regressions between HRV, age and cerebral oxygenation parameters. During wake, age had a positive association with LF power, reflecting increased parasympathetic and sympathetic activity with increasing age for both control and SDB groups. This association was also evident during sleep in controls, but was absent in children with SDB. In controls, during wake TOI had a positive, and FTOE a negative association with age. During sleep, TP, LF and HF power were significant, negative determinants of TOI and positive determinants of FTOE. These associations were not seen in children with SDB during wake or sleep. SDB disrupts the normal maturation of the autonomic control of heart rate and the association between HRV and cerebral oxygenation exhibited by non‐snoring control children of primary school age. These results highlight the impact SDB has on cardiovascular control and the potential impact on adverse cardiovascular outcomes.

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Section: Discussionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

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Sleep disordered breathing in children disrupts the maturation of autonomic control of heart rate and its association with cerebral oxygenation

Walter

Tamanyan

Weichard

et al. 2018

The Journal of Physiology

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“…Previous studies have investigated changes in NIRS parameters associated with different types of apnea. Significant oscillations of cerebral hemodynamics with declined HbO 2 , tHb, and TOI/StO 2 accompanied by a synchronized increase in HHb were observed during the initiation of apneic episodes, and reverse changes of hemoglobin indices accompanied by inconsistent changes in tHb were obtained after the termination of apnea (71)(72)(73)(74)(75)(76)(77)(78)(79). An example of the changes of NIRS indices in response to apnea is shown in Figure 4.…”

Section: Cerebral Hemodynamics Under Different Sleep-disordered Breatmentioning

confidence: 98%

A Review of Cerebral Hemodynamics During Sleep Using Near-Infrared Spectroscopy

Ren

Jiang

et al. 2020

Front. Neurol.

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Investigating cerebral hemodynamic changes during regular sleep cycles and sleep disorders is fundamental to understanding the nature of physiological and pathological mechanisms in the regulation of cerebral oxygenation during sleep. Although sleep neuroimaging methods have been studied and have been well-reviewed, they have limitations in terms of technique and experimental design. Neurologists are convinced that Near-infrared spectroscopy (NIRS) provides essential information and can be used to assist the assessment of cerebral hemodynamics, and numerous studies regarding sleep have been carried out based on NIRS. Thus, a brief historical overview of the sleep studies using NIRS will be helpful for the biomedical students, academicians, and engineers to better understand NIRS from various perspectives. In this study, the existing literature on sleep studies is reviewed, and an overview of the NIRS applications is synthesized and provided. The paper first reviews the application scenarios, as well as the patterns of fluctuation of NIRS, which includes the investigation in regular sleep and sleep-disordered breathing. Various factors such as different sleep stages, populations, and degrees of severity were considered. Furthermore, the experimental design and signal processing, as well as the regulation mechanisms involved in regular and pathological sleep, are investigated and discussed. The strengths and weaknesses of the existing NIRS applications are addressed and presented, which can direct further NIRS analysis and utilization.

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Resting‐State Cerebral Hemodynamics is Associated With Problem Behaviors in Pediatric Sleep‐Disordered Breathing

Isaiah

Teplitzky

Dontu

et al. 2023

Otolaryngol.--head neck surg.

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ObjectiveUntreated sleep‐disordered breathing (SDB) is associated with problem behaviors in children. The neurological basis for this relationship is unknown. We used functional near‐infrared spectroscopy (fNIRS) to assess the relationship between cerebral hemodynamics of the frontal lobe of the brain and problem behaviors in children with SDB.Study DesignCross‐sectional.SettingUrban tertiary care academic children's hospital and affiliated sleep center.MethodsWe enrolled children with SDB aged 5 to 16 years old referred for polysomnography. We measured fNIRS‐derived cerebral hemodynamics within the frontal lobe during polysomnography. We assessed parent‐reported problem behaviors using the Behavioral Response Inventory of Executive Function Second Edition (BRIEF‐2). We compared the relationships between (i) the instability in cerebral perfusion in the frontal lobe measured fNIRS, (ii) SDB severity using apnea‐hypopnea index (AHI), and (iii) BRIEF‐2 clinical scales using Pearson correlation (r). A p < .05 was considered significant.ResultsA total of 54 children were included. The average age was 7.8 (95% confidence interval, 7.0‐8.7) years; 26 (48%) were boys and 25 (46%) were Black. The mean AHI was 9.9 (5.7‐14.1). There is a statistically significant inverse relationship between the coefficient of variation of perfusion in the frontal lobe and BRIEF‐2 clinical scales (range of r = 0.24‐0.49, range of p = .076 to <.001). The correlations between AHI and BRIEF‐2 scales were not statistically significant.ConclusionThese results provide preliminary evidence for fNIRS as a child‐friendly biomarker for the assessment of adverse outcomes of SDB.

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Age Effects on Cerebral Oxygenation and Behavior in Children with Sleep-disordered Breathing

Abstract: 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.

Cited by 31 publications

References 38 publications

Sleep disordered breathing in children disrupts the maturation of autonomic control of heart rate and its association with cerebral oxygenation

Sleep disordered breathing in children disrupts the maturation of autonomic control of heart rate and its association with cerebral oxygenation

A Review of Cerebral Hemodynamics During Sleep Using Near-Infrared Spectroscopy

Resting‐State Cerebral Hemodynamics is Associated With Problem Behaviors in Pediatric Sleep‐Disordered Breathing

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