Ricci Anna, He Fan, Fang Jidong, Calhoun Susan L, Vgontzas Alexandros N, Liao Duanping, Younes Magdy, Bixler Edward O, Fernandez-Mendoza Julio
Sleep Research & Treatment Center, Department of Psychiatry & Behavioral Health, Penn State College of Medicine, 500 University Dr., Hershey, PA, 17033 USA.
Department of Public Health Sciences, Penn State College of Medicine, A210 Public Health Sciences, Hershey, PA, 17033 USA.
Sleep Med. 2021 Jul;83:271-279. doi: 10.1016/j.sleep.2021.05.002. Epub 2021 May 11.
Brain maturation is reflected in the sleep electroencephalogram (EEG) by a decline in non-rapid eye movement (NREM) slow wave activity (SWA) throughout adolescence and a related decrease in sleep depth. However, this trajectory and its sex and pubertal differences lack replication in population-based samples. We tested age-related changes in SWA (0.4-4 Hz) power and odds ratio product (ORP), a standardized measure of sleep depth.
We analyzed the sleep EEG of 572 subjects aged 6-21 y (48% female, 26% racial/ethnic minority) and 332 subjects 5-12 y followed-up at 12-22 y. Multivariable-adjusted analyses tested age-related cross-sectional and longitudinal trajectories of SWA and ORP.
SWA remained stable from age 6 to 10, decreased between ages 11 and 17, and plateaued from age 18 to 21 (p-cubic<0.001); females showed a longitudinal decline 23% greater than males by 13 y, while males experienced a steeper slope after 14 y and their longitudinal decline was 21% greater by 19 y. More mature adolescents (75% female) experienced a greater longitudinal decline in SWA than less mature adolescents by 14 y. ORP showed an age-related increasing trajectory (p-linear<0.001) with no sex or pubertal differences.
We provide population-level evidence for the maturational decline and sex and pubertal differences in SWA in the transition from childhood to adolescence, while introducing ORP as a novel metric in youth. Along with previous studies, the distinct trajectories observed suggest that age-related changes in SWA reflect brain maturation and local/synaptic processes during this developmental period, while those of ORP may reflect global/state control of NREM sleep depth.
在整个青春期,非快速眼动(NREM)慢波活动(SWA)的下降以及相关的睡眠深度降低反映在睡眠脑电图(EEG)中,这体现了大脑的成熟过程。然而,这种变化轨迹及其性别和青春期差异在基于人群的样本中缺乏重复性验证。我们测试了SWA(0.4 - 4Hz)功率和优势比乘积(ORP,一种睡眠深度的标准化测量指标)与年龄相关的变化。
我们分析了572名年龄在6 - 21岁的受试者(48%为女性,26%为种族/族裔少数群体)以及332名年龄在5 - 12岁且在12 - 22岁进行随访的受试者的睡眠脑电图。多变量调整分析测试了SWA和ORP与年龄相关的横断面和纵向变化轨迹。
SWA在6至10岁时保持稳定,在11至17岁之间下降,在18至21岁时趋于平稳(p - 三次方<0.001);到13岁时,女性的纵向下降幅度比男性大23%,而男性在14岁后斜率更陡,到19岁时其纵向下降幅度比女性大21%。更成熟的青少年(75%为女性)到14岁时,SWA的纵向下降幅度比不太成熟的青少年更大。ORP呈现出与年龄相关的上升轨迹(p - 线性<0.001),无性别或青春期差异。
我们提供了人群水平的证据,证明了从童年到青春期SWA的成熟性下降以及性别和青春期差异,同时引入ORP作为青少年的一种新指标。与之前的研究一起,观察到的不同变化轨迹表明,SWA与年龄相关的变化反映了这一发育时期大脑的成熟以及局部/突触过程,而ORP的变化可能反映了NREM睡眠深度的整体/状态控制。