Study on cerebral oxygen saturation in children with sleep‐disordered breathing

To explore the association between the severity of sleep-disordered breathing, different types of respiratory events, peripheral oxygen saturation (SpO₂), age and sleep stage on cerebral oxygen saturation (rSO₂) in children. We enrolled children aged 4-14 years who were treated for snoring or mouth breathing at the Sleep Center of Beijing Children's Hospital, from February 2022 to July 2022. All children completed polysomnography, and SpO₂, rSO₂, and heart rate (HR) were recorded synchronously. A total of 70 children were included, including 16 (22.9%) with primary snoring, 38 (54.3%) with mild obstructive sleep apnea (OSA), and 16 (22.9%) with moderate-to-severe OSA. There were no significant differences in the mean rSO₂ or minimum rSO₂ among the primary snoring, mild OSA, and moderate-to-severe OSA groups (all p > 0.05). A total of 1119 respiratory events were included in the analysis. Regardless of the type of respiratory event, rSO₂ and HR changes occur prior to fluctuations in SpO₂. A mixed-effects model showed that ΔrSO₂ was positively correlated with ΔSpO₂, duration of respiratory event, mixed and obstructive apnea, central apnea, while negatively correlated with age and rapid eye movement (REM) sleep stage (all p < 0.05). Larger rSO₂ fluctuations were impacted by a greater ΔSpO₂, longer duration of respiratory events, younger age, apnea-related respiratory events and non-REM sleep stage. Thus, sleep disordered breathing in younger children warrants more attention. More research is needed to determine whether REM sleep has special protective effects on rSO₂.