Cerebral Oxygenation During Respiratory Events in Children with Sleep-Disordered Breathing and Associated Disorders

Abstract

Objectives: To evaluate changes in cerebral oxygenation by means of near-infrared spectroscopy during respiratory events in children with sleep-disordered breathing (SDB) and associated disorders.

Study design: Sixty-five children suspected of having SDB underwent a respiratory polygraphy with simultaneous recording of cerebral oxygenation indices. Respiratory events were analyzed by type of event, duration, variations of pulse oximetry (oxygen saturation [SpO₂]), cerebral tissue oxygenation index (TOI), and heart rate. Data were categorized according to the severity of SDB and age.

Results: There were 540 obstructive and mixed apneas, 172 central apneas, and 393 obstructive hypopneas analyzed. The mean decreases in SpO₂ and TOI were 4.1 ± 3.1% and 3.4 ± 2.8%, respectively. The mean TOI decrease was significantly smaller for obstructive hypopnea compared with apneas. The TOI decrease was significantly less in children with mild SDB as compared with those with moderate-to-severe SDB and in children >7 years as compared with those <7 years old. TOI decreases correlated significantly with SpO₂ decreases, duration of event, and age, regardless of the type of event. In a multivariable regression model, predictive factors of TOI decreases were the type of respiratory event, SpO₂ decrease, apnea-hypopnea index, and age.

Conclusions: In children with SDB and associated disorders, cerebral oxygenation variations depend on the type of respiratory event, severity of SDB, and age.

Keywords: cerebral oxygenation; children; near-infrared spectroscopy; polygraphy; sleep-disordered breathing.