Ji Jiapeng, Wang Yuqing, Chen Bolin, Xu Xueyun, Lv Meng
Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, 215003, Jiangsu, China.
BMC Pediatr. 2025 Mar 1;25(1):156. doi: 10.1186/s12887-025-05500-3.
Children with obstructive sleep apnea (OSA) can develop cognitive impairments. Urinary adrenaline (EPI), norepinephrine (NE) and gamma-aminobutyric acid (GABA) are elevated, and taurine is decreased in children with OSA. The purpose of this study was to investigate the above-mentioned neurotransmitter levels in children with and without OSA, and explore their association with OSA-related cognitive impairments.
Children underwent overnight polysomnography (PSG) for habitual snoring or mouth breathing in the pediatric sleep center from February 2023 to February 2024, as well as a group of healthy controls were enrolled in this study. Pediatric Quality of Life Inventory (PedsQL) and Child Behavior Checklist (CBCL) were used to evaluate the cognitive function of these children. Morning urine samples were collected to measure the urinary neurotransmitter levels.
This study recruited 74 children with OSA, 30 children with primary snoring (PS) and 16 healthy controls. In the comparison of PedsQL scores, social function (85(75, 100)), school function (65.88 ± 18.52), and total scores (74.15 ± 12.74) of OSA group were significantly lower than that of non-OSA group (P < 0.05); OSA group also exhibited increased withdrawn (1 (0, 2)) and attention problems (2 (1, 5)) scores in CBCL than non-OSA group (P < 0.05). A total of 39 cases in the OSA group (PedsQL total score below 77.42) were considered to have mild cognitive impairment (MCI), who had higher urinary EPI (190.68 ± 38.77 ng/ml) and lower taurine (432.20 ± 53.52 ng/ml) levels than both PS and OSA without MCI groups (P < 0.001). Logistic regression analysis showed that high levels of urinary NE (OR = 1.027, 95%CI: 1.002 ~ 1.052) and low levels of taurine (OR = 0.982, 95%CI: 0.969 ~ 0.995) are significantly associated with cognitive impairment in children with OSA, and their combination has a larger area under the curve (0.695) for prediction, with a sensitivity of 64.1% and specificity of 68.6% (P = 0.004).
Children with OSA presented impaired cognitive functions such as school, social function deficits and attention problems. Measuring urinary EPI and taurine levels may contribute to the prediction of OSA-related cognitive impairments.
阻塞性睡眠呼吸暂停（OSA）患儿可出现认知障碍。OSA患儿尿肾上腺素（EPI）、去甲肾上腺素（NE）和γ-氨基丁酸（GABA）升高，而牛磺酸降低。本研究旨在调查有或无OSA患儿上述神经递质水平，并探讨其与OSA相关认知障碍的关系。
2023年2月至2024年2月，在儿科睡眠中心对因习惯性打鼾或口呼吸接受整夜多导睡眠图（PSG）检查的患儿以及一组健康对照者进行研究。使用儿童生活质量量表（PedsQL）和儿童行为量表（CBCL）评估这些儿童的认知功能。收集晨尿样本以测量尿神经递质水平。
本研究纳入74例OSA患儿、30例原发性打鼾（PS）患儿和16例健康对照者。在PedsQL评分比较中，OSA组的社会功能（85（75，100））、学校功能（65.88±18.52）和总分（74.15±12.74）显著低于非OSA组（P<0.05）；OSA组在CBCL中的退缩（1（0，2））和注意力问题（2（1，5））评分也高于非OSA组（P<0.05）。OSA组中共有39例（PedsQL总分低于77.42）被认为有轻度认知障碍（MCI），其尿EPI水平（190.68±38.77 ng/ml）高于PS组和无MCI的OSA组，而牛磺酸水平（432.20±53.52 ng/ml）低于这两组（P<0.001）。逻辑回归分析显示，尿NE水平高（OR=1.027，95%CI：1.002～1.052）和牛磺酸水平低（OR=0.982，95%CI：0.969～0.995）与OSA患儿的认知障碍显著相关，二者联合预测的曲线下面积更大（0.695），敏感度为64.1%，特异度为68.6%（P=0.004）。
OSA患儿存在学校、社会功能缺陷和注意力问题等认知功能受损。测量尿EPI和牛磺酸水平可能有助于预测OSA相关的认知障碍。
