Association between mental health condition and quantitative electroencephalography spectral power in children with sleep disordered breathing

doi:10.11852/zgetbjzz2023-1190

Chinese Journal of Child Health Care ›› 2024, Vol. 32 ›› Issue (10): 1055-1063.DOI: 10.11852/zgetbjzz2023-1190

• Original Articles • Previous Articles Next Articles

Association between mental health condition and quantitative electroencephalography spectral power in children with sleep disordered breathing

JIN Linglin¹, ZHAI Feng¹, WANG Guanghai^2,3,4,5, CHEN Jie¹

1. Department of Otolaryngology,Shanghai Children′s Medical Center,School of Medicine,Shanghai Jiao Tong University, Shanghai,200127,China;
2. Department of Developmental and Behavioral Pediatrics,Shanghai Children′s Medical Center, School of Medicine,Shanghai Jiao Tong University;
3. Pediatric Translational Medicine Institution,Shanghai Children′s Medical Center,School of Medicine,Shanghai Jiao Tong University;
4. MOE-Shanghai Key Laboratory of Children′s Environmental Health,Xinhua Hospital,School of Medicine,Shanghai Jiao Tong University;
5. Shanghai Center for Brain Science and Brain-Inspired Technology

Received:2023-11-13 Revised:2024-03-20 Online:2024-10-10 Published:2024-10-11
Contact: CHEN Jie,E-mail:13611715123@163.com

睡眠呼吸障碍儿童的心理健康状况与定量脑电图频谱功率的关联

金玲凛¹, 翟丰¹, 王广海^2,3,4,5, 陈洁¹

1.上海交通大学医学院附属上海儿童医学中心耳鼻咽喉科,上海 200127;
2.上海交通大学医学院附属上海儿童医学中心发育行为儿科;
3.上海交通大学医学院附属上海儿童医学中心儿科转化医学研究所;
4.上海交通大学医学院附属新华医院环境与儿童健康教育部和上海市重点实验室;
5.上海脑科学与类脑研究中心

通讯作者: 陈洁,E-mail:13611715123@163.com上海交通大学医学院附属上海儿童医学中心耳鼻咽喉科,上海,200127,E-mail:13611715123@163.com
作者简介:金玲凛(1998-),女,硕士研究生在读,主要研究方向为儿童睡眠呼吸障碍的情绪损害。
基金资助:
国家自然科学基金(81900939);国家自然科学基金(82071493);国家科技创新2030重大专项(2021ZD0204200)

Abstract

Abstract: Objective To explore the associations between mental health condition and quantitative electroencephalography (qEEG) in children with sleep disordered breathing (SDB),so as to timely detect and treat the emotional complications of SDB and to ensure the healthy neuropsychological development of children with SDB. Methods From December 2020 to October 2022,an overnight polysomnography (PSG) was conducted at Shanghai Children′s Medical Center in children with SDB symptoms,meanwhile their qEEG data were collected.The parents of the subjects completed the Children′s Depression Inventory (CDI),the Spence Children′s Anxiety Scale-Parental Version (SCAS-P) or the Preschool Anxiety Scale (PAS),along with the Obstructive Sleep Apnea Questionnaire-18 (OSA-18).Two independent-sample t-test, Wilcoxon rank-sum test and χ² testand Fisher exact testwere employed to compare variables between different groups of SDB children. Finally, multiple linear regression model concerning SDB children′s mental health were built. Results A total of 105 cases of 3- to 12-year-old SDB patients were included in this study.The CDI score of school-age SDB children[6.50(3.00,9.00)] were higher than those of preschoolers [3.00(1.00,6.00)],with a statistically significant difference (Z=701.00,P=0.010).Relative δ and θ power were negatively correlated with social phobia symptoms in preschool SDB children (β=-1.06,-0.62,P＜0.05) and with interpersonal problems in school-age children (β=-3.62,-2.36,P＜0.05). Conclusions PSG is the essential test for the diagnosis of SDB,from which qEEG can be obtained.qEEG features are linked to the mental state of children with SDB,which promotes the early detection of mental health issues in children with SDB through easily accessible and accurate Methods in clinical practice.

Key words: anxiety, depression, electroencephalography, sleep disordered breathing, social interaction, children

摘要： 目的本研究旨在分析睡眠呼吸障碍(SDB)儿童心理健康状况与定量脑电图(qEEG)频谱特征之间的联系,以便及时发现并诊治SDB的情绪并发症,从而保障SDB儿童神经心理的健康发育。方法 2020年12月-2022年10月期间于上海儿童医学中心对存在SDB症状的儿童进行整夜多导睡眠监测(PSG),同时收集其睡眠qEEG数据。受试者父母填写儿童抑郁量表(CDI),Spence儿童焦虑量表家长版(SCAS-P)[或学龄前焦虑量表(PAS)],以及阻塞性睡眠呼吸暂停问卷疾病特异性生活质量调查表(OSA-18)。采用独立样本t检验、Wilcoxon秩和检验和χ²检验和Fisher精确检验比较SDB儿童各个组别之间的变量,并构建SDB儿童心理健康的多重线性回归模型。结果本研究共纳入105例3~12岁SDB患儿。学龄期SDB患儿的CDI评分[6.50(3.00,9.00)]高于学龄前期组[3.00(1.00,6.00)],差异有统计学意义(Z=701.00,P=0.010)。相对δ和θ功率与学龄前SDB儿童的社交恐惧症状(β=-1.06,-0.62,P<0.05)和学龄儿童的人际关系问题(β=-3.62,-2.36,P<0.05)得分均呈负相关。结论 PSG是诊断SDB的必要检查手段,PSG中的qEEG特征与SDB患儿情绪状况相关,为日后在临床实践中对于SDB患儿心理健康问题的早期发现提供了便捷准确的方法。

关键词: 焦虑, 抑郁, 脑电图, 睡眠呼吸障碍, 社会交往, 儿童

CLC Number:

R766

JIN Linglin, ZHAI Feng, WANG Guanghai, CHEN Jie. Association between mental health condition and quantitative electroencephalography spectral power in children with sleep disordered breathing[J]. Chinese Journal of Child Health Care, 2024, 32(10): 1055-1063.

金玲凛, 翟丰, 王广海, 陈洁. 睡眠呼吸障碍儿童的心理健康状况与定量脑电图频谱功率的关联[J]. 中国儿童保健杂志, 2024, 32(10): 1055-1063.

References

[1] Kaditis AG,Alonso Alvarez ML,Boudewyns A,et al.ERS statement on obstructive sleep disordered breathing in 1-to 23-month-old children[J].Eur Respir J,2017,50(6):1700985.
[2] Liu J,Liu X,Ji X,et al.Sleep disordered breathing symptoms and daytime sleepiness are associated with emotional problems and poor school performance in children[J].Psychiatry Res,2016,242:218-225.
[3] Liu SJ,Liu ZZ,Wang ZY,et al.Sleep disordered breathing symptoms are associated with depressive symptoms:A longitudinal study of Chinese adolescents[J].J Affect Disord,2021,293:492-501.
[4] Park KM,Kim SY,Sung D,et al.The relationship between risk of obstructive sleep apnea and other sleep problems,depression,and anxiety in adolescents from a community sample[J].Psychiatry Res,2019,280:112504.
[5] Mitchell RB,Archer SM,Ishman SL,et al.Clinical practice guideline:Tonsillectomy in children (update)[J].Otolaryngol Head Neck Surg,2019,160(1_suppl):S1-S42.
[6] Malhi GS,Mann JJ.Depression[J].Lancet,2018,392(10161):2299-2312.
[7] Scaini S,Belotti R,Ogliari A,et al.A comprehensive meta-analysis of cognitive-behavioral interventions for social anxiety disorder in children and adolescents[J].J Anxiety Disord,2016,42:105-112.
[8] Lee S,Zhao X,Davis KA,et al.Quantitative EEG predicts outcomes in children after cardiac arrest[J].Neurology,2019,92(20):e2329-e2338.
[9] Hamann C,Rusterholz T,Studer M,et al.Association between depressive symptoms and sleep neurophysiology in early adolescence[J].J Child Psychol Psychiatry,2019,60(12):1334-1342.
[10] Mcvoy M,Lytle S,Fulchiero E,et al.A systematic review of quantitative EEG as a possible biomarker in child psychiatric disorders[J].Psychiatry Res,2019,279:331-344.
[11] Toenders YJ,Van Velzen LS,Heideman IZ,et al.Neuroimaging predictors of onset and course of depression in childhood and adolescence:A systematic review of longitudinal studies[J].Dev Cogn Neurosci,2019,39:100700.
[12] Umemoto A,Panier LYX,Cole SL,et al.Resting posterior alpha power and adolescent major depressive disorder[J].J Psychiatr Res,2021,141:233-240.
[13] Poole KL,Schmidt LA.Frontal brain delta-beta correlation,salivary cortisol,and social anxiety in children[J].J Child Psychol Psychiatry,2019,60(6):646-654.
[14] Rosenzweig I,Glasser M,Polsek D,et al.Sleep apnoea and the brain:a complex relationship[J].Lancet Respir Med,2015,3(5):404-414.
[15] Chang CH,Chen SJ,Liu CY.Pediatric sleep apnea and depressive disorders risk:A population-based 15-year retrospective cohort study[J].PLoS One,2017,12(7):e0181430.
[16] Oldehinkel AJ,Verhulst FC,Ormel J.Mental health problems during puberty:Tanner stage-related differences in specific symptoms.the trails study[J].J Adolesc,2011,34(1):73-85.
[17] Essau CA,Lewinsohn PM,Seeley JR,et al.Gender differences in the developmental course of depression[J].J Affect Disord,2010,127(1-3):185-190.
[18] Janssen X,Martin A,Hughes AR,et al.Associations of screen time,sedentary time and physical activity with sleep in under 5s:A systematic review and meta-analysis[J].Sleep Med Rev,2020,49:101226.
[19] 倪鑫.中国儿童阻塞性睡眠呼吸暂停诊断与治疗指南(2020)[J].中国循证医学杂志,2020,20(8):883-900.
Ni X.Chinese guideline for the diagnosis and treatment of childhood obstructive sleep apnea (2020)[J].Chin J Evid Based Med,2020,20(8):883-900.(in Chinese)
[20] Kaditis AG,Alonso Alvarez ML,Boudewyns A,et al.Obstructive sleep disordered breathing in 2-to 18-year-old children:diagnosis and management[J].Eur Respir J,2016,47(1):69-94.
[21] Young T,Peppard PE,Gottlieb DJ.Epidemiology of obstructive sleep apnea:A population health perspective[J].Am J Respir Crit Care Med,2002,165(9):1217-1239.
[22] Bertisch SM,Li W,Buettner C,et al.Nightly sleep duration,fragmentation,and quality and daily risk of migraine[J].Neurology,2020,94(5):e489-e496.
[23] Walia HK,Mehra R.Practical aspects of actigraphy and approaches in clinical and research domains[J].Handb Clin Neurol,2019,160:371-379.
[24] Berry RB,Budhiraja R,Gottlieb DJ,et al.Rules for scoring respiratory events in sleep:Update of the 2007 AASM manual for the scoring of sleep and associated events.deliberations of the sleep apnea definitions task force of the american academy of sleep medicine[J].J Clin Sleep Med,2012,8(5):597-619.
[25] Delorme A,Makeig S.EEGLAB:An open source toolbox for analysis of single-trial EEG dynamics including independent component analysis[J].J Neurosci Methods,2004,134(1):9-21.
[26] Walter LM,Tamanyan K,Weichard AJ,et al.Age and autonomic control,but not cerebral oxygenation,are significant determinants of EEG spectral power in children[J].Sleep,2019,42(9):zsz118.
[27] Li J,You J,Yin G,et al.Electroencephalography theta/beta ratio decreases in patients with severe obstructive sleep apnea[J].Nat Sci Sleep,2022,14:1021-1030.
[28] Yang JS,Nicholas CL,Nixon GM,et al.Determining sleep quality in children with sleep disordered breathing:EEG spectral analysis compared with conventional polysomnography[J].Sleep,2010,33(9):1165-1172.
[29] Timbremont B,Braet C,Dreessen L.Assessing depression in youth:Relation between the children′s depression inventory and a structured interview[J].J Clin Child Adolesc Psychol,2004,33(1):149-157.
[30] Sokratis S,Christos Ζ,Despo P,et al.Prevalence of depressive symptoms among schoolchildren in Cyprus:A cross-sectional descriptive correlational study[J].Child Adolesc Psychiatry Ment Health,2017,11:7.
[31] Shomaker LB,Tanofsky-Kraff M,Stern EA,et al.Longitudinal study of depressive symptoms and progression of insulin resistance in youth at risk for adult obesity[J].Diabetes Care,2011,34(11):2458-2463.
[32] 俞大维,李旭.儿童抑郁量表(CDI)在中国儿童中的初步运用[J].中国心理卫生杂志,2000,14(4):225-227.
Yu DW, Li X. Preliminary use of the children′s depression inventory in China[J]. Chin Ment Health J, 2000,14(4):225-227. (in Chinese)
[33] Wang M,Meng Q,Liu L,et al.Reliability and validity of the spence children′s anxiety scale for parents in mainland chinese children and adolescents[J].Child Psychiatry Hum Dev,2016,47(5):830-839.
[34] Evans R,Thirlwall K,Cooper P,et al.Using symptom and interference questionnaires to identify recovery among children with anxiety disorders[J].Psychol Assess,2017,29(7):835-843.
[35] Wang M,Zhao J.Anxiety disorder symptoms in Chinese preschool children[J].Child Psychiatry Hum Dev,2015,46(1):158-166.
[36] Hu H,Wu T,Wang S,et al.Association between family structure and anxiety disorder among pre-schoolers:A cross-sectional study in urban Chongqing,China[J].Front Psychiatry,2021,12:626377.
[37] Franco RA,Rosenfeld RM,Rao M.First place-resident clinical science award 1999.quality of life for children with obstructive sleep apnea[J].Otolaryngol Head Neck Surg,2000,123(1 Pt 1):9-16.
[38] Huang YS,Hwang FM,Lin CH,et al.Clinical manifestations of pediatric obstructive sleep apnea syndrome:Clinical utility of the Chinese-version obstructive sleep apnea questionaire-18[J].Psychiatry Clin Neurosci,2015,69(12):752-762.
[39] Lee CH,Kim YJ,Lee SB,et al.Psychological screening for the children with habitual snoring[J].Int J Pediatr Otorhinolaryngol,2014,78(12):2145-2150.
[40] Edwards C,Mukherjee S,Simpson L,et al.Depressive symptoms before and after treatment of obstructive sleep apnea in men and women[J].J Clin Sleep Med,2015,11(9):1029-1038.
[41] Bahammam AS,Kendzerska T,Gupta R,et al.Comorbid depression in obstructive sleep apnea:An under-recognized association[J].Sleep Breath,2016,20(2):447-456.
[42] Douglas N,Young A,Roebuck T,et al.Prevalence of depression in patients referred with snoring and obstructive sleep apnoea[J].Intern Med J,2013,43(6):630-634.
[43] Palmer CA,Alfano CA.Sleep architecture relates to daytime affect and somatic complaints in clinically anxious but not healthy children[J].J Clin Child Adolesc Psychol,2017,46(2):175-187.
[44] Kurth S,Ringli M,Geiger A,et al.Mapping of cortical activity in the first two decades of life:A high-density sleep electroencephalogram study[J].J Neurosci,2010,30(40):13211-13219.
[45] Campbell IG,Feinberg I.Longitudinal trajectories of non-rapid eye movement delta and theta EEG as indicators of adolescent brain maturation[J].Proc Natl Acad Sci USA,2009,106(13):5177-5180.
[46] Wilhelm I,Groch S,Preiss A,et al.Widespread reduction in sleep spindle activity in socially anxious children and adolescents[J].J Psychiatr Res,2017,88:47-55.
[47] Meers JM,Ferri R,Bruni O,et al.Sleep spindle density is associated with worry in children with generalized anxiety disorder and healthy controls[J].J Affect Disord,2020,260:418-425.
[48] Appleton SL,Vakulin A,D′rozario A,et al.Quantitative electroencephalography measures in rapid eye movement and nonrapid eye movement sleep are associated with apnea-hypopnea index and nocturnal hypoxemia in men[J].Sleep,2019,42(7):zsz092.
[49] Gosselin N,Baril AA,Osorio RS,et al.Obstructive sleep apnea and the risk of cognitive decline in older adults[J].Am J Respir Crit Care Med,2019,199(2):142-148.

Association between mental health condition and quantitative electroencephalography spectral power in children with sleep disordered breathing

睡眠呼吸障碍儿童的心理健康状况与定量脑电图频谱功率的关联

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