Impairments in Attention in Occasionally Snoring Children: An Event-Related Potential Study

Objective—To determine whether minimal snoring is benign in children. Procedure—22 rarely snoring children (mean age=6.9 years, 11 females) and age- and sexmatched controls participated in an auditory oddball task wearing 128-electrode nets. Parents completed Conner’s Parent Rating Scales-Revised Long (CPRS-R:L). Results—Snorers scored significantly higher on 4 CPRS-R:L subscales. Stepwise regression indicated that two ERP variables from a region of the ERP that peaked at 844 ms post-stimulus onset predicted CPRS-R:L ADHD Index scores. Conclusions—Occasional snorers according to parental report do exhibit ADHD-like behaviors. Basic sensory processing is longer than in controls, suggesting that delayed frontal activation requires more effort in snorers

Impairments in attention in occasionally snoring children: An event-related potential study.

Objective: To determine whether minimal snoring is benign in children. Procedure: 22 rarely snoring children (mean age = 6.9 years, 11 females) and age- and sex-matched controls participated in an auditory oddball task wearing 128-electrode nets. Parents completed the Conners Parent Rating Scales–Revised Long (CPRS–R:L). Results: Snorers scored significantly higher on four CPRS-R:L subscales. Stepwise regression indicated that two ERP variables from a region of the ERP that peaked at 844 msec post-stimulus onset predicted CPRS-R:L Attention Deficit Hyperactivity Disorder (ADHD) Index scores. Conclusions: Occasional snorers, according to parental report, do exhibit ADHD-like behaviors. Basic sensory processing is longer than in controls, suggesting that delayed frontal activation requires more effort in snorers

Impairments in Attention in Occasionally Snoring Children: An Event-Related Potential Study

Objective—To determine whether minimal snoring is benign in children. Procedure—22 rarely snoring children (mean age=6.9 years, 11 females) and age- and sexmatched controls participated in an auditory oddball task wearing 128-electrode nets. Parents completed Conner’s Parent Rating Scales-Revised Long (CPRS-R:L). Results—Snorers scored significantly higher on 4 CPRS-R:L subscales. Stepwise regression indicated that two ERP variables from a region of the ERP that peaked at 844 ms post-stimulus onset predicted CPRS-R:L ADHD Index scores. Conclusions—Occasional snorers according to parental report do exhibit ADHD-like behaviors. Basic sensory processing is longer than in controls, suggesting that delayed frontal activation requires more effort in snorers

Nocturnal Oximetry-based Evaluation of Habitually Snoring Children

Rationale: The vast majority of children around the world undergoing adenotonsillectomy for obstructive sleep apnea–hypopnea syndrome (OSA) are not objectively diagnosed by nocturnal polysomnography because of access availability and cost issues. Automated analysis of nocturnal oximetry (nSpO2), which is readily and globally available, could potentially provide a reliable and convenient diagnostic approach for pediatric OSA. Methods: DeidentifiednSpO2 recordings froma total of 4,191 children originating from13 pediatric sleep laboratories around the worldwere prospectively evaluated after developing and validating an automated neural network algorithm using an initial set of single-channel nSpO2 recordings from 589 patients referred for suspected OSA. Measurements and Main Results: The automatically estimated apnea–hypopnea index (AHI) showed high agreement with AHI from conventional polysomnography (intraclass correlation coefficient, 0.785) when tested in 3,602 additional subjects. Further assessment on the widely used AHI cutoff points of 1, 5, and 10 events/h revealed an incremental diagnostic ability (75.2, 81.7, and 90.2% accuracy; 0.788, 0.854, and 0.913 area under the receiver operating characteristic curve, respectively). Conclusions: Neural network–based automated analyses of nSpO2 recordings provide accurate identification of OSA severity among habitually snoring children with a high pretest probability of OSA. Thus, nocturnal oximetry may enable a simple and effective diagnostic alternative to nocturnal polysomnography, leading to more timely interventions and potentially improved outcomes.Supported in part by project VA037 U16 from the Consejer´ıa de Educacio´ n de la Junta de Castilla y Leo´ n and the European Regional Development Fund (FEDER), project RTC-2015-3446-1 from the Ministerio de Econom´ıa y Competitividad and FEDER, and project 153/2015 of the Sociedad Espan˜ ola de Neumolog´ıa y Cirug´ıa Tora´ cica (SEPAR). L.K.-G. is supported by NIH grant 1R01HL130984. M.F.P. was supported by a Fellowship Educational grant award from the Kingdom of Saudi Arabia. D.´A. was in receipt of a Juan de la Cierva grant from the Ministerio de Econom´ıa y Competitividad. The funders played no role in the study design, data collection, data analysis, interpretation, and writing of the manuscript

Nocturnal Oximetry-based Evaluation of Habitually Snoring Children

Rationale: The vast majority of children around the world undergoing adenotonsillectomy for obstructive sleep apnea–hypopnea syndrome (OSA) are not objectively diagnosed by nocturnal polysomnography because of access availability and cost issues. Automated analysis of nocturnal oximetry (nSpO2), which is readily and globally available, could potentially provide a reliable and convenient diagnostic approach for pediatric OSA. Methods: DeidentifiednSpO2 recordings froma total of 4,191 children originating from13 pediatric sleep laboratories around the worldwere prospectively evaluated after developing and validating an automated neural network algorithm using an initial set of single-channel nSpO2 recordings from 589 patients referred for suspected OSA. Measurements and Main Results: The automatically estimated apnea–hypopnea index (AHI) showed high agreement with AHI from conventional polysomnography (intraclass correlation coefficient, 0.785) when tested in 3,602 additional subjects. Further assessment on the widely used AHI cutoff points of 1, 5, and 10 events/h revealed an incremental diagnostic ability (75.2, 81.7, and 90.2% accuracy; 0.788, 0.854, and 0.913 area under the receiver operating characteristic curve, respectively). Conclusions: Neural network–based automated analyses of nSpO2 recordings provide accurate identification of OSA severity among habitually snoring children with a high pretest probability of OSA. Thus, nocturnal oximetry may enable a simple and effective diagnostic alternative to nocturnal polysomnography, leading to more timely interventions and potentially improved outcomes.Supported in part by project VA037 U16 from the Consejer´ıa de Educacio´ n de la Junta de Castilla y Leo´ n and the European Regional Development Fund (FEDER), project RTC-2015-3446-1 from the Ministerio de Econom´ıa y Competitividad and FEDER, and project 153/2015 of the Sociedad Espan˜ ola de Neumolog´ıa y Cirug´ıa Tora´ cica (SEPAR). L.K.-G. is supported by NIH grant 1R01HL130984. M.F.P. was supported by a Fellowship Educational grant award from the Kingdom of Saudi Arabia. D.´A. was in receipt of a Juan de la Cierva grant from the Ministerio de Econom´ıa y Competitividad. The funders played no role in the study design, data collection, data analysis, interpretation, and writing of the manuscript

Intermittent Hypoxia-Induced Cognitive Deficits Are Mediated by NADPH Oxidase Activity in a Murine Model of Sleep Apnea

Background: In rodents, exposure to intermittent hypoxia (IH), a hallmark of obstructive sleep apnea (OSA), is associated with neurobehavioral impairments, increased apoptosis in the hippocampus and cortex, as well as increased oxidant stress and inflammation. Excessive NADPH oxidase activity may play a role in IH-induced CNS dysfunction. Methods and Findings: The effect of IH during light period on two forms of spatial learning in the water maze and well as markers of oxidative stress was assessed in mice lacking NADPH oxidase activity (gp91phox _/Y) and wild-type littermates. On a standard place training task, gp91phox _/Y displayed normal learning, and were protected from the spatial learning deficits observed in wild-type littermates exposed to IH. Moreover, anxiety levels were increased in wild-type mice exposed to IH as compared to room air (RA) controls, while no changes emerged in gp91phox _/Y mice. Additionally, wild-type mice, but not gp91phox _/Y mice had significantly elevated levels of NADPH oxidase expression and activity, as well as MDA and 8-OHDG in cortical and hippocampal lysates following IH exposures. Conclusions: The oxidative stress responses and neurobehavioral impairments induced by IH during sleep are mediated, at least in part, by excessive NADPH oxidase activity, and thus pharmacological agents targeting NADPH oxidase may provid

Child Sleep and Socioeconomic Context in the Development of Cognitive Abilities in Early Childhood

Despite a robust literature examining the association between sleep problems and cognitive abilities in childhood, little is known about this association in toddlerhood, a period of rapid cognitive development. The present study examined the association between various sleep problems, using actigraphy, and performance on a standardized test of cognitive abilities, longitudinally across three ages (30, 36, and 42 months) in a large sample of toddlers (N = 493). Results revealed a between-subject effect in which the children who had more delayed sleep schedules on average also showed poorer cognitive abilities on average but did not support a within-subjects effect. Results also showed that delayed sleep explains part of the association between family socioeconomic context and child cognitive abilities