1006 Respiratory Cycle-Related EEG Changes (RCREC) Observed During Sleep of Neonates with Myelomeningocele

SLEEP · 2025-05-01

Abstract Introduction Respiratory Cycle-Related EEG Changes (RCREC) measured during the sleep of children and adults may represent subtle cortical microarousals exacerbated by labored breathing in obstructive sleep apnea. However, the existence of RCREC has not been investigated previously in newborns. Methods Nine North American Fetal Therapy Network centers collaborated in a prospective polysomnographic study (at ≥32 weeks postmenstrual age) of sleep among 171 neonates (gestational age at birth 30-41 weeks) with myelomeningocele in neonatal intensive care units. The RCREC for NREM and REM sleep were computed (AJRCCM 2005;171:652-8) for the entire night in 5 frequency ranges -- delta 2-4 Hz, theta 4-8 Hz, alpha 8-12 Hz, sigma 12-15 Hz, and beta 15-18 Hz) -- using C3-M2 EEG and the nasal-oral thermocouple signal. The RCREC were compared to gestational age at birth, and the apnea-hypopnea index (AHI). Results Statistically-significant RCREC (ANOVA, p< 0.01) appeared in at least some frequency ranges in most neonates during NREM sleep (delta n=170, theta 164, alpha 159, sigma 160, beta 164), and during REM sleep (delta 170, theta 163, alpha 147, sigma 161, beta 163). In NREM sleep, the RCREC varied inversely with gestational age (delta: Spearman rho=-0.16, p=0.03; theta: rho=-0.34, p=< 0.0001; alpha: rho=-0.45, p=< 0.0001; sigma: rho=-0.23, p=0.003; beta: rho=-0.21, p=0.007). Theta and alpha RCREC increased with AHI (rho=0.18, p=0.02, and rho=0.25, p=0.001, respectively). In REM sleep, RCREC also varied inversely with gestational age (delta: rho=-0.24, p=0.001; theta: rho=-0.20, p=0.009; alpha: rho=-0.28, p=0.0002; sigma: rho=-0.22, p=0.004; beta: rho=-0.18, p=0.02). Only alpha RCREC varied with AHI during active sleep (rho=0.18, p=0.02). Conclusion These data demonstrate RCREC in neonates for the first time. As in older individuals, only limited associations appear with AHI. Moreover, the synchronization between EEG power and the respiratory cycle increases, on average, with lower gestational age at birth. Although these data are specific to infants with myelomeningocele, we have also found RCREC in preterm newborns without MMC (unpublished observations). Previous findings in children and adults that RCREC may predict daytime sleepiness, as well or better than standard polysomnographic measures (Sleep 2006;29:495-503), suggest that infant RCREC merits additional study. Support (if any) This work was supported by NIH grant R01HL147261

Defining Risk of Postoperative Obstructive Sleep Apnea in Patients With 22q11.2DS Undergoing Pharyngeal Flap Surgery for Velopharyngeal Dysfunction Using Polysomnographic Evaluation

The Cleft Palate-Craniofacial Journal · 2020-01-24 · 19 citations

OBJECTIVE: To determine pre- and postoperative prevalence of obstructive sleep apnea (OSA) in patients with 22q11.2 deletion syndrome (DS) undergoing wide posterior pharyngeal flap (PPF) surgery for velopharyngeal dysfunction (VPD). DESIGN: Retrospective study using pre- and postoperative polysomnography (PSG) to determine prevalence of OSA. Medical records were reviewed for patients' medical comorbidities. Parents were surveyed about snoring. SETTING: Academic tertiary care pediatric hospital. PATIENTS: Forty patients with laboratory confirmed 22q11.2DS followed over a 6-year period. INTERVENTIONS: Pre- and postoperative PSG, speech evaluation, and parent surveys. MAIN OUTCOME MEASURE: Severity and prevalence of OSA, defined by obstructive apnea hypopnea index (OAHI), before and after PPF surgery to determine whether PPF is associated with increased risk of OSA. RESULTS: = .330). Prevalence of clinically significant OSA (OAHI ≥ 5) was identical pre- and postoperatively (2 of 40), with both cases having severe-range OSA requiring positive airway pressure therapy. All other patients had mild-range OSA. Nasal resonance was graded as severe preoperatively in 85% of patients. None were graded as severe postoperatively. No single patient factor or parent-reported concern predicted risk of OSA (OAHI ≥ 1.5). CONCLUSIONS: Patients with 22q11.2DS are medically complex and are at increased risk of OSA at baseline. Wide PPF surgery for severe VPD does not significantly increase risk of OSA. Careful perioperative planning is essential to optimize both speech and sleep outcomes.

Parasomnias

2018-12-13 · 1 citations

Williams Syndrome

2018-12-13

0739 Employee Age Associates with Work-Related Sleep Outcomes

SLEEP · 2018-04-01

Tiredness in workers can lead to absenteeism, errors, and accidents in addition to negative mood, mistrust, hostility, resentment, and increased sensitivity in the workplace. Decreased work performance can have a significant impact for companies, as a recent study estimated the cost of fatigue-related productivity losses at four U.S. based companies to be $54 million dollars annually. The purpose of this study was to assess the association between employee age, sleep quality and quantity, and performance and behavior in the workplace. A sample of employees at OSF HealthCare Saint Francis Medical Center (n=573, age 18–69) completed a 20-question survey about various aspects of sleep, including quantity and quality, and aspects of the workplace, including mood, efficiency, and interactions. Univariate and multivariate analyses were completed, and age was treated as a continuous variable. Subjects who reported unrefreshing sleep (n=325, 56.7%), when compared with subjects who reported refreshing sleep (n=248, 42.3%), were more likely to report sleepiness, tiredness, or fatigue affecting workplace mood and interactions (n=48, n=11 respectively, (14.77%, 4.44%) p<.0001). Younger subjects were more likely than older subjects to report unrefreshing sleep (p=.0002), but there was no difference in reported duration of sleep between younger and older subjects (p=.219). Additionally, younger subjects were more likely than older subjects to report that sleepiness affected workplace mood and interactions (p>.0001) and efficiency (p=.0023). The findings that younger age and unrefreshing sleep are independently associated with adverse workplace outcomes, and that younger workers are more likely to have unrefreshing sleep, suggest that it may be worthwhile to address sleep health in employees, particularly younger ones. Support (If Any):

Kleine-Levin Syndrome

Paediatric Respiratory Reviews · 2016-12-24 · 10 citations

Brain tumor presenting as somnambulism in an adolescent

Elsevier eBooks · 2016-08-12

Does Increased Consolidated Nighttime Sleep Facilitate Attentional Control? A Pilot Study of Nap Restriction in Preschoolers

Journal of Attention Disorders · 2015-02-02 · 25 citations

OBJECTIVE: The aim of this study is to understand the impact of a 5-day period of nap restriction on sleep patterns and cognitive function in typically developing preschoolers, aged 3 to 4 years. METHOD: Following 1 week of baseline assessment, 28 children were randomly assigned to either a "napping as usual" group ( n = 15) or a 5-day period of nap restriction ( n = 13). Sleep was assessed with sleep logs and actigraphy; cognition was assessed at baseline and at the end of the intervention week. RESULTS: No group differences in sleep or cognitive function were observed at baseline. For the no-nap group, the 5-day period of daytime nap restriction resulted in increased nighttime sleep. Children in the no-nap group also showed a significant improvement in attentional control compared with baseline, whereas no such changes were observed among children in the napping-as-usual group. CONCLUSION: In preschool children who typically take naps, short-term nap restriction is associated with increased nighttime sleep and may contribute to improved attentional function.

Prevalence of Periodic Limb Movements during Sleep in Normal Children

SLEEP · 2014-07-31 · 47 citations

STUDY OBJECTIVES: Although the American Academy of Sleep Medicine (AASM) mandates that periodic limb movements during sleep (PLMS) be scored on every polysomnogram, and considers a periodic limb movement index (PLMI) > 5/h abnormal in children, there is a lack of community-derived data regarding the prevalence of PLMS in children, and no data to support this cutoff value. Therefore, the aim of this study was to determine the prevalence of PLMS in a sample of normal children. DESIGN: Retrospective study. PARTICIPANTS: 195 healthy, non-snoring children aged 5-17 years, recruited from the community, who underwent polysomnography for research purposes. METHODS: PLMS were scored using the AASM 2007 criteria. MEASUREMENTS AND RESULTS: The group age (median [IQR]) was 12.9 [10-15] years, and 58% were male. Sleep architecture was normal, and the obstructive apnea hypopnea index was 0.1 [0-0.3]/h. The median PLMI was 0/h, ranging from 0 to 35.5/h. Fifteen (7.7%) subjects had a PLMI > 5/h, and only 3 (1.5%) met the adult pathologic criterion of more than 15/h. Use of the 95th percentile PLMI cutoff of 7.2/h produced little difference in categorization between groups. Children with a PLMI > 5/h had a higher arousal index than those with a lower PLMI (11.6 [8.8-14.6] vs 8.1 [6.1-9.9]/h, respectively, P = 0.003). CONCLUSIONS: This study provides normative data to the field and supports the clinical periodic limb movement index cutoff of > 5/h based on both prevalence and the correlate of increased sleep fragmentation. Periodic limb movements during sleep are infrequent in normal children recruited from the community. CITATION: Marcus CL, Traylor J, Gallagher PR, Brooks LJ, Huang J, Koren D, Katz L, Mason TB, Tapia IE. Prevalence of periodic limb movements during sleep in normal children.

List of Contributors

Elsevier eBooks · 2014-10-18