Attentional function and nocturnal electroencephalography theta/beta ratio in children with rapid-eye movement sleep-related obstructive sleep apnea.

OBJECTIVE

To investigate daytime attentional function in children with rapid eye movement (REM) sleep-related obstructive sleep apnea (OSA; REM-OSA) and its relationship with sleep electroencephalography theta/beta ratio (TBR).

METHODS

One-hundred-and-three children (aged 6-11 years) with snoring/mouth breathing were recruited from Beijing Children's Hospital. Participants completed the Attentional Networks Test for Interactions and Vigilance - executive and arousal components (ANTI-Vea) and underwent polysomnography. Groups were classified according to the obstructive apnea/hypopnea index (OAHI): 20 non-OSA, 53 non-REM-OSA, and 30 REM-OSA. The TBR of the frontal, central, and occipital regions was analyzed.

RESULTS

Children with REM-OSA exhibited higher reaction time variability for executive vigilance and more errors during invalid condition ANTI-Vea trials than the non-REM-OSA group. The REM-OSA group exhibited higher TBRs in the frontal and central regions during all sleep stages than the non-OSA and non-REM-OSA groups and a higher TBR in the frontal and central region during REM sleep than the non-OSA group. Occipital TBR did not differ among the three groups. Reaction time variability for executive vigilance correlated positively with OAHI during REM sleep (OAHIREM). TBR in the frontal and central regions during all sleep stages and TBR in the frontal region during REM sleep correlated positively with the number of errors during invalid condition ANTI-Vea trials.

CONCLUSIONS

Children with REM-OSA exhibited impaired attentional function, characterized by increased reaction time variability for executive vigilance and poorer performance in the invalid condition attention task trials. The OAHIREM and TBR reflect distinct dimensions of attentional impairment in pediatric OSA.