Weichard Aidan J, Walter Lisa M, Hollis Samantha L, Nixon Gillian M, Davey Margot J, Horne Rosemary S C, Biggs Sarah N
The Ritchie Centre, Hudson Institute of Medical Research, Clayton, Victoria, Australia.
The Ritchie Centre, Hudson Institute of Medical Research, Clayton, Victoria, Australia; Department of Paediatrics, Monash University, Clayton, Victoria, Australia.
Sleep Med. 2016 Sep;25:49-55. doi: 10.1016/j.sleep.2016.06.004. Epub 2016 Jun 21.
It has been suggested that impaired dissipation of slow-wave activity (SWA) in children with sleep-disordered breathing (SDB) may be a potential mechanism for daytime dysfunction. We aimed to examine whether resolution of SDB resulted in normalisation of SWA dissipation and whether this was associated with improved cognition and behaviour.
Children (aged 3-6 y) diagnosed with SDB and age-matched non-snoring control children were followed up for 3 y after a baseline study. At the follow-up, children were categorised into control (N = 13), resolved SDB (N = 15) and unresolved SDB (N = 14). Delta activity on the electroencephalogram over the sleep period was used to calculate SWA and a battery of cognitive assessments and behaviour questionnaires were conducted at both time points.
There was no change in the average SWA between the baseline and follow-up and no differences between the groups. Cognitive and behavioural performance in the resolved group did not improve to control levels. However, decreased SWA at the beginning of the sleep period (β = -0.04, p = 0.002) and a decrease in obstructive apnoea-hypopnoea index (β = -2.2, p = 0.022) between the baseline and follow-up predicted improvements in measures of sustained attention. Increased SWA at the beginning of the sleep period between the baseline and follow-up predicted worsening of externalising behaviour (β = 0.02, p = 0.039).
This study suggests that resolution of SDB is not associated with changes in the dissipation of SWA. However, the association between decreases in SWA and improvements in cognitive and behavioural outcomes suggest that irrespective of disease, children whose quantitative sleepiness improves have improved attention and reduced externalising behaviours.
有人提出，睡眠呼吸障碍（SDB）儿童中慢波活动（SWA）消散受损可能是日间功能障碍的一个潜在机制。我们旨在研究SDB的缓解是否会导致SWA消散正常化，以及这是否与认知和行为改善相关。
在一项基线研究后，对诊断为SDB的儿童（3 - 6岁）和年龄匹配的不打鼾对照儿童进行了3年的随访。在随访时，儿童被分为对照组（N = 13）、已缓解的SDB组（N = 15）和未缓解的SDB组（N = 14）。利用睡眠期间脑电图上的δ活动来计算SWA，并在两个时间点进行了一系列认知评估和行为问卷调查。
基线和随访之间平均SWA没有变化，各组之间也没有差异。已缓解组的认知和行为表现没有改善到对照组水平。然而，睡眠期开始时SWA的降低（β = -0.04，p = 0.002）以及基线和随访之间阻塞性呼吸暂停低通气指数的降低（β = -2.2，p = 0.022）预测了持续注意力测量指标的改善。基线和随访之间睡眠期开始时SWA的增加预测了外化行为的恶化（β = 0.02，p = 0.039）。
这项研究表明，SDB的缓解与SWA消散的变化无关。然而，SWA降低与认知和行为结果改善之间的关联表明，无论疾病如何，定量嗜睡改善的儿童注意力得到改善，外化行为减少。
