Quantitative electroencephalography Spectral Power and Emotional Disturbances in Children with Sleep Disordered Breathing

Purpose Sleep disordered breathing (SDB) can result in emotional symptoms among children. This study aimed to establish associations of quantitative electroencephalography (qEEG) alterations during different sleep stages with depression and anxiety in children with SDB. Methods A total of 147 children aged 3–12 years with SDB were included in the study. They were divided into two groups: primary snoring (n = 88, 44% female) and obstructive sleep apnea (n = 59, 34% female). Children underwent whole-night polysomnography (PSG) at the hospital, during which quantitative electroencephalography (qEEG) data were acquired. Prior to the test, parents of SDB children completed the Obstructive Sleep Apnea Questionnaire-18 (OSA-18), the Spence Children’s Anxiety Scale–Parent version (SCAS-P) or the Preschool Anxiety Scale (PAS), and the Children's Depression Inventory (CDI). Results Compared to the PS group, the OSA group had lower mean SpO2, sleep duration and efficiency. Sleep efficiency mediated the association between the OSA/PS exposure and the OSA-18 outcome, with the negative estimate of -1.514 (95% CI: -3.658, -0.01; p < .01). OSA children exhibited higher CDI scores compared to the PS children of the same age. Notably, the NREM3 EEG slowing ratio was negatively correlated with anxiety levels, and the NREM2 EEG slowing ratio was negatively correlated with depressive symptoms. Conclusions QEEG alterations during different sleep stages are linked to emotional disturbances of children suffering from SDB. The EEG slowing ratio in NREM sleep may be a useful indicator for the nocturnal electrophysiology in children with SDB, potentially linked to emotional disturbances.