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 Researchers can't say the brain changes actually cause problems for
children at home or school, but they do say the condition, known as
obstructive sleep apnea (OSA), has been tied to behavior and
cognitive problems.
"It really does seem that there is a change in the brain or that the
brain is affected," said study author Paul Macey, who is director of
technology and innovation at the University of California, Los
Angeles School of Nursing.
Macey and colleagues write in Scientific Reports that up to 5
percent of all children are affected by OSA. The condition causes
the child's airway to become blocked, which ultimately causes the
brain to go without oxygen for short periods of time and may wake
the child up.
Previous studies on lab animals and adults with OSA have shown
changes in the brain due to nerve cells dying, they add.
For the new study, the researchers used magnetic resonance imaging
to analyze the volume of children's gray matter, which is the
outermost layer of the brain that allows for higher levels of
functioning like problem solving.
They compared brain scans from 16 children with OSA and 200 children
without the condition. All the youngsters were between 7 and 11
years old.
Overall, children with OSA had decreases in gray matter volume in
areas of the brain important for controlling cognition and mood,
compared to the other children.
Macey, who is also affiliated with the UCLA Brain Research
Institute, said it's unclear how closely changes in the brain are
connected to behavior, cognition and other issues.
"We know these two things are happening, but we’re not sure how much
the reduced gray matter tracks with poor scores," he told Reuters
Health.
The researchers also can't say exactly why OSA is tied to reduce
gray matter volume among children. A lack of oxygen may kill off
brain cells or it may stop the brain from properly developing, for
example.
Macey's team wants to see whether treating the condition helps
children get back on track with their healthy peers.
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"If we did that we would know better how people recover from it or
not," he said.
Dr. Eliot Katz, of Harvard Medical School and Boston Children’s
Hospital, said previous research shows treating OSA by removing
tonsils and adenoids improves children's school performance,
behavior and sleep-related issues. Evidence is mixed on whether it
improves cognition.
Katz, who wasn't involved with the new study, said the previous
research on problems faced by children with OSA - like behavior and
cognition - is fitting nicely with the brain imaging studies.
"This is really the first large, really well controlled study that
has found decrements in gray matter in children with obstructive
sleep apnea," he told Reuters Health.
He said parents should discuss symptoms of OSA with children's
healthcare providers. Those symptoms include chronic snoring and
gaps in breathing while they sleep.
"Sleep complaints are often not addressed in well child care
visits," he said, or in training programs for pediatricians.
He advises parents to "take a brief phone video of the breathing
pattern that’s concerning to them and show it to their
pediatrician."
Macey said daytime tiredness and mood issues can also be symptoms of
OSA. Children who are overweight and obese are at higher risk for
the condition.
SOURCE: http://bit.ly/2mY9IFX Scientific Reports, online March 17,
2017.
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