Cerebral oxygenation during respiratory events in children with sleep-disordered breathing

Introduction: Childhood sleep disordered breathing (SDB) is associated with neurodevelopmental disorders and structural brain abnormalities. Near infrared spectroscopy (NIRS) allows a continuous noninvasive measurement of cerebral tissue oxygenation. Objectives: To analyze changes in cerebral oxygenation during respiratory events in children with SDB, and to evaluate the impact of the type of respiratory events, the severity of SDB and age. Methods: Children with suspected SDB underwent a respiratory polygraphy with simultaneous recording of cerebral oxygenation indexes with NIRS. Respiratory events were analyzed according to their type (obstructive-mixed apneas (OMA), central apneas (CA), and hypopneas (H)), duration, and simultaneous changes in pulse oximetry (SpO2) and tissue oxygenation index (TOI). The data were categorized according to SDB severity and age. Results: Five hundred forty OMA, 172 CA and 393 H were analyzed. Mean SpO2 and TOI decreases were 4.1±3.1% and 3.4±2.8%, respectively. TOI decrease correlated with SpO2 decrease, duration of the respiratory event and age for the 3 types of respiratory events. TOI decrease was significantly smaller in patients with mild SDB, and in children = 7 years old. In a model of multivariate regression, predictive factors of TOI decrease were the type of respiratory event, SpO2 decrease, apnea-hypopnea index and age. Conclusion: Changes in cerebral oxygenation are determined by the type of respiratory events, SDB severity and patient9s age.