Variation in Sleep Stability with Differences in Severity of Sleep-Disordered Breathing in Children

Abstract

Objectives: The aim of this study was to analyze the association between obstructive sleep apnea (OSA) severity and various cardiopulmonary coupling (CPC) parameters in children with OSA.

Study design: Retrospective cross-sectional study.

Methods: A cross-sectional study was conducted among 117 children (aged 7.96 ± 3.54 years, 86 male) who underwent both full-night polysomnography (PSG) and CPC for suspicion of sleep-disordered breathing (SDB). We analyzed the association between various CPC and PSG findings.

Results: The apnea-hypopnea index (AHI) was negatively correlated with high frequency coupling (HFC, r = -0.374, P < .001) and very low frequency coupling (VLFC, r = -0.192, P = .038) and positively correlated with low frequency coupling (LFC, r = 0.503, P < .001), elevated low frequency coupling (e-LFC, r = 0.475, P < .001), and narrow and broad band e-LFC (e-LFC_NB and e-LFC_BB ; r = 0.221, P = .016 and r = 0.468, P < .001, respectively). The arousal index was negatively correlated with HFC (r = - 0.466, P < .001) and positively correlated with LFC, e-LFC, e-LFC_NB , and e-LFC_BB (r = 0.543, r = 0.460, r = 0.239, and r = 0.445, respectively; all P < .001). In addition, we also found a significant difference in various CPC values according to OSA severity.

Conclusion: CPC parameters accurately reflect sleep fragmentation and OSA severity in children. Thus, we can verify objective sleep quality using CPC analysis, which is a simple method of analyzing sleep stability in children with SDB.

Level of evidence: 4 Laryngoscope, 131:435-439, 2021.

Keywords: Sleep-disordered breathing; cardiopulmonary coupling; child; polysomnography; sleep stability.