PECULIARITIES OF NEUROPSYCHOLOGICAL STATUS AND STRUCTURE OF NIGHT SLEEP IN CHILDREN WITH OBSTRUCTIVE APNEA SYNDROME

Abstract

Aim. To study the clinical peculiar features of sleep and its structure by the data of night polysomnographic study and peculiarities of development of higher cortical functions (HCF) in children with obstructive sleep apnea/hypopnea syndrome (OSAHS). Materials and methods. Clinical, neuropsychological and polysomnographic examination of 25 preschool-age children with OSAHS was carried out. The group of сomparison included 10 healthy children. Clinical study of sleep was assessed, using specially developed by the author sleep questionnaire; HCF status was estimated by means of neuropsychological study, adapted for child age (E.G. Simernitskaya). Results. Some peculiar features of organizing sleep in children with obstructive night apnea were detected. There was demonstrated a reduced duration of drowsiness, decreased duration of fast sleep phase, reduced number of sleep cycles and vegetative disorders in the form more frequent episodes of tachycardia, confirming sympathicotonia during night sleep. Kinesthetic dyspraxia was registered in 76 % of observations among apnea children. Differences in anxiety level were registered in extreme values of anxiety index (AI); AI > 50 %, considered as high, was revealed in 72 % of patients with OSAHS. High productivity and stability of attention ( S = 1.00-1.25) was noted in 35 % of control children, in OSAHS group this index was 4 %. Conclusions. Reduced duration of fast sleep phase in children with apnea is a matter of principle. Not only snore is a marker of OSAHS, apnea can occur without marked concomitant snoring. The role of connective tissue dysplasia in OSAHS formation is to be discussed. Muscular hypotonia formed can increase constriction of the upper airways, especially within the fast sleep phase and provoke apnea/hypopnea episodes.