Sleep disorders lead to gray matter alterations children: a systematic review of cortical and subcortical points

Morphological changes in the brain cortex can disrupt central nervous system activity, often resulting from neuroinflammation, neurodegenerative diseases, and sleep disorders. Sleep disorders are linked to alterations in the thickness and volume of the cortex in adults; however, this relationship requires further investigation in children. This systematic review aims to explore the volume and thickness of gray matter and the cortex in children with sleep disorders. This systematic review was conducted based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria, and the principle of non-bias was respected. All the articles from 2014 to 2024 were extracted from the Web of Science, PubMed, and Scopus databases. This study extracted sleep disorders, cortical and gray matter alterations, and alterations anatomy from children up to 18 years old. Eleven studies were identified with inclusion criteria that addressed sleep-disordered breathing (SDB), obstructive sleep apnea, and periodic limb movements of sleep. The mean age of the children involved was 8.89 ± 3.22 years, with a predominance of males in most studies. Notably, the thickness of the cerebral cortex in the right anterior caudate cingulate and right cuneiform regions was significantly elevated following obstructive SDB. The gray matter volume exhibited both increases in certain areas and decreases in others, a phenomenon that applies to all sleep disorders. Sleep disorders alter cortical thickness and gray matter volume, which, when synthesized, provided us with a pattern of point-to-point changes in children brain anatomy. Our results show that changes in cortical volume and morphological thickness are not uniform, and that there may be increases or decreases in gray matter at different points.