The Sleep Structure And EEG Arousals In Sleep-disordered Breathing Children Exhibiting Attention Deficit Hyperactivity Disorder

Objectives:1. To study the specific sleep structure of SDB children with ADHD.2. To study the specific EEG arousal characteristics of SDB children with ADHD,comparing these arousals to those of children with SDB only.3. To discuss specific features of EEG arousals between children exhibiting PSand children exhibiting OSAHS,providing appropriate treatment for childrenexhibiting PS.Methods:A total of121children with suspected SDB were evaluated by nocturnalvideo-PSG. All had been independently examined by specialized child psychiatristsand52were confirmed to meet the ADHD criteria of the Diagnostic and StatisticalManual of Mental Disorders (DSM-IV). The EEG total arousal index (the ARtotI),the respiratory arousal index (the RAI), the limb arousal index (the LAI), and thespontaneous arousal index (SAI) were scored using general AASM criteria, andvalues in ADHD/SDB and SDB-only (OSAHS, primary snoring (PS)) childrencompared.Results:1. The differences of sleep structureThe differences of sleep structures are focuing on I sleep stage and REM stage:children with SDB group express increased I sleep stage and disincreased REMsleep stage,accompany with ADHD or not; while,It’s more significant about theincreasing of I sleep stage and disincreasing of REM stage in SDB children exhitingADHD. 2. The changes of EEG arousals in SDB children exhiting ADHDThere are no significant differences of EEG arousals in SDB children withADHD during the whole night sleep, comparing to SDB children, even if we wescore EEG arousals varibles during the REM sleep stage and NREM sleep stageseparately.EEG arousals increase dramatically in NREM sleep.3. The changes of EEG arousals of children with Primary SnoringSignificant differences in EEG arousal indices (ARtotI, RAI, LAI, and SAI)were apparent between children with SDB and controls,all indices were higher inchildren with SDB；In children with PS, the LAI was higher than in children withOSAHS and controls, especially during NREM sleep. Also, the RAI was notablyhigher in children with OSAHS than in the other two groups.Conclusions:1. The stageⅠincreased profoundly and REM sleep stage decreased significantlyin SDB children with ADHD,comparing to children with SDB alone.Thus it’s moreprone to cause a series of clinical symptoms such as restless sleep, frequentnocturnal awakening, restless motor activity, inattention, poor school performance, etal.2. No significant differences appeared in EEG arousals between SDB childrenwith ADHD and SDB children alone. Maybe we use different research techniques,the results will be different.This will provide possible references for futureresearchers.3. LAI usefully reflects changes in microsleep structure in PS children. Theconnection between sleep structure and EEG arousal changes in PS children suggeststhat such children may be appropriately treated.