Sleep Architecture and Respiratory Disturbances in Children with Obstructive Sleep Apnea

Little is known regarding sleep architecture in children with the obstructive sleep apnea syndrome (OSAS). We hypothesized that sleep architecture was normal, and that apnea increased over the course of the night, in children with OSAS. We analyzed polysomnographic studies from 20 children with OSAS...

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Bibliographic Details
Published in:American journal of respiratory and critical care medicine 2000-08, Vol.162 (2), p.682-686
Main Authors: GOH, DANIEL Y. T, GALSTER, PATRICIA, MARCUS, CAROLE L
Format: Article
Language:English
Subjects:
Apnea - physiopathology
Biological and medical sciences
Child
Child, Preschool
Female
Humans
Male
Medical sciences
Pneumology
Polysomnography
Respiration
Respiratory system : syndromes and miscellaneous diseases
Sleep Apnea, Obstructive - physiopathology
Sleep Stages - physiology
Sleep, REM
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Summary:Little is known regarding sleep architecture in children with the obstructive sleep apnea syndrome (OSAS). We hypothesized that sleep architecture was normal, and that apnea increased over the course of the night, in children with OSAS. We analyzed polysomnographic studies from 20 children with OSAS and 10 control subjects. Sleep architecture was similar between the groups. Of obstructive apneas 55% occurred during rapid eye movement (REM) sleep. The apnea index, apnea duration, and degree of desaturation were greater during REM than non-REM sleep. OSAS data from the first and third periods of the night (periods A and C) were compared. Both the overall and the REM apnea index increased between periods A and C (11 to 25/h, p < 0.02; and 24 to 51/h, p < 0.01, respectively). There was no difference in Sa(O(2)) over time. Spontaneous arousals, but not respiratory-related arousals, were more frequent during non-REM than REM sleep; these did not change from periods A to C. We conclude that children with OSAS have normal sleep stage distribution. OSAS is predominantly a REM phenomenon in children. Obstructive apnea worsens over the course of the night, independent of the changing amounts of REM sleep. We speculate that this increase in apnea severity may be secondary to upper airway muscle fatigue, changes in upper airway neuromotor control, or changes in REM density.
ISSN:1073-449X
1535-4970
DOI:10.1164/ajrccm.162.2.9908058