Association between slow wave activity, cognition and behaviour in children with sleep disordered breathing

Publication date: Available online 21 June 2016
Source:Sleep Medicine
Author(s): Aidan J Weichard, Lisa M Walter, Samantha L Hollis, Gillian M Nixon, Margot J Davey, Rosemary SC Horne, Sarah N Biggs
BackgroundIt 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.MethodsChildren (aged 3-6y) diagnosed with SDB and age-matched non-snoring control children were followed-up 3-years after a baseline study. At 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 timepoints.ResultsThere was no change in average SWA between baseline and follow-up and no differences between 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 Hypopnea Index (β = -2.2, p=0.022) between baseline and follow-up predicted improvements in measures of sustained attention. Increased SWA at the beginning of the sleep period between baseline and follow-up predicted worsening of externalising behaviour (β = 0.02, p=0.039).ConclusionsThis 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.



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