Obstructive sleep apnea and P300 abnormalities in children with attention deficit

Abstract

Obstructive sleep apnea (OSA), that causes abnormal breathing or chronic intermittent hypoxia during sleep, can cause attention and working memory deficits which can be related to cognitive impairment throughout the developing nervous system. Aims: To verify the ability to sustain attention in children and adolescents diagnosed with OSA compared to a control group. 80 participants of a local school (49 boys and 31 girls) aged 6 to 17 years (mean 10.85 , ±2.25), with attention complaints by the school, accepted to participate in this study and underwent overnight polysomnography and P300 evoked potential test. This test was divided into three repeated series with 10 min interval between series and lasting 15 min each series. None of the participants had been using medication or had previous diagnoses of developing mental disorder. Among the 80 participants, 26 (32.5%) received the diagnosis of OSA and 61 (76.3) had varied abnormalities at P300 tests, from these 26 met both OSA and ADD deficit attention disorder criteria, 19 participants had no altered results and composed the control group. Considering the entire sample, OSA was significantly correlated with lower amplitudes ( r = .79; r = .77 and r = .81, p = .000) and longer latencies ( r = .60; r = .57; r = 76, p = .000) in all three tests, respectively. Two-Way ANOVA and repeated measures analyses showed no effect of age and gender on the P300 waves, though boys had a greater variability in all values. The apnea and hypoapnea index (IAH) had mainly effect on amplitudes of all tests and at latency of test 3 ( F > 2.23, p < .010) and OSA diagnosis had effect over all P300 variables ( F > 34.39, p < .000). Also, the group with OSA also presented decay in amplitude along the three tests, as showed by the repeated measures analyses, over all the three P300 amplitude measures ( F = 297.57, p = .000), but not to latency, differently from the group without OSA that kept the values at the same levels during the three tests. This study has found evidence of the relationship between OSA and P300 evoked potentials, amplitudes and latencies. These findings are in accordance with the literature showing that sleep disturbances might disrupt sustaining attention abilities leading to school complaints of learning capacity. Also, this may help to clarify the diagnosis of attention deficit disorder, when sleep disorder is present. To the University of Brasilia, FAHUB and CNPq.