Effectiveness of the sleep apnea-specific hypoxic burden and sleep breathing impairment index in assessing cognitive impairment in children with obstructive sleep apnea

PurposeThis study investigated cognitive impairment in children with obstructive sleep apnea (OSA) by evaluating the utility of sleep apnea-specific hypoxic burden (SASHB) and sleep breathing impairment index (SBII) compared to the obstructive apnea-hypopnea index (OAHI).MethodsA retrospective analy...

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Main Authors: Simin Zhu, Yanuo Zhou, Chendi Lu, Zitong Wang, Lina Ma, Xiaoxin Niu, Yushan Xie, Zihan Xia, Yonglong Su, Yuqi Yuan, Jiayi Yang, Rui Lu, Xinru Lv, Wei Hou, Yani Feng, Xiaoyong Ren, Yewen Shi
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Pediatrics
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Online Access:https://www.frontiersin.org/articles/10.3389/fped.2025.1628961/full
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author Simin Zhu
Yanuo Zhou
Chendi Lu
Zitong Wang
Lina Ma
Xiaoxin Niu
Yushan Xie
Zihan Xia
Yonglong Su
Yuqi Yuan
Jiayi Yang
Rui Lu
Xinru Lv
Wei Hou
Yani Feng
Xiaoyong Ren
Yewen Shi
author_facet Simin Zhu
Yanuo Zhou
Chendi Lu
Zitong Wang
Lina Ma
Xiaoxin Niu
Yushan Xie
Zihan Xia
Yonglong Su
Yuqi Yuan
Jiayi Yang
Rui Lu
Xinru Lv
Wei Hou
Yani Feng
Xiaoyong Ren
Yewen Shi
author_sort Simin Zhu
collection DOAJ
description PurposeThis study investigated cognitive impairment in children with obstructive sleep apnea (OSA) by evaluating the utility of sleep apnea-specific hypoxic burden (SASHB) and sleep breathing impairment index (SBII) compared to the obstructive apnea-hypopnea index (OAHI).MethodsA retrospective analysis included 141 children with suspected OSA from Xi'an Jiaotong University Second Affiliated Hospital (October 2021–October 2024), categorized into OSA (n = 104) and non-OSA (n = 37) groups based on OAHI. Demographic, polysomnography (PSG), and event-related potential (ERP) data were collected. Cognitive function (full, verbal, and performance IQ: FIQ, VIQ, PIQ) was assessed using the China-Wechsler Intelligence Scale (C-WISC). Correlations between cognitive scores, ERP parameters, OAHI, SASHB, and SBII were analyzed.ResultsOSA children exhibited higher rates of snoring/sleep suffocation, prolonged apnea/hypoventilation durations, reduced mean/minimum SaO2, lower REM sleep, and elevated N3 sleep. OAHI and SASHB were higher in the OSA group, but SBII showed no group difference. OSA children had prolonged P300/N100 latencies and lower FIQ, VIQ, and PIQ scores. FIQ inversely correlated with OAHI, SASHB, and SBII; after adjusting for age, sex, and BMI, FIQ remained negatively associated with SBII. SASHB correlated with FIQ only in children <6 years, while OAHI showed no significant correlation. VIQ in younger children negatively correlated with SASHB/SBII, but only with OAHI in older children. PIQ in younger children correlated with OAHI, while no correlations existed in older children. P300 latency positively correlated with OAHI; other ERP parameters showed no associations.ConclusionOSA children demonstrate significant cognitive decline and ERP abnormalities. SASHB and SBII exhibit stronger correlations with cognitive impairment than OAHI, particularly in younger children, highlighting their potential as precise metrics for evaluating cognitive deficits in pediatric OSA.
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spelling doaj-art-e77deeffcf094214bdc12bd0f91263d72025-08-20T03:56:03ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-07-011310.3389/fped.2025.16289611628961Effectiveness of the sleep apnea-specific hypoxic burden and sleep breathing impairment index in assessing cognitive impairment in children with obstructive sleep apneaSimin ZhuYanuo ZhouChendi LuZitong WangLina MaXiaoxin NiuYushan XieZihan XiaYonglong SuYuqi YuanJiayi YangRui LuXinru LvWei HouYani FengXiaoyong RenYewen ShiPurposeThis study investigated cognitive impairment in children with obstructive sleep apnea (OSA) by evaluating the utility of sleep apnea-specific hypoxic burden (SASHB) and sleep breathing impairment index (SBII) compared to the obstructive apnea-hypopnea index (OAHI).MethodsA retrospective analysis included 141 children with suspected OSA from Xi'an Jiaotong University Second Affiliated Hospital (October 2021–October 2024), categorized into OSA (n = 104) and non-OSA (n = 37) groups based on OAHI. Demographic, polysomnography (PSG), and event-related potential (ERP) data were collected. Cognitive function (full, verbal, and performance IQ: FIQ, VIQ, PIQ) was assessed using the China-Wechsler Intelligence Scale (C-WISC). Correlations between cognitive scores, ERP parameters, OAHI, SASHB, and SBII were analyzed.ResultsOSA children exhibited higher rates of snoring/sleep suffocation, prolonged apnea/hypoventilation durations, reduced mean/minimum SaO2, lower REM sleep, and elevated N3 sleep. OAHI and SASHB were higher in the OSA group, but SBII showed no group difference. OSA children had prolonged P300/N100 latencies and lower FIQ, VIQ, and PIQ scores. FIQ inversely correlated with OAHI, SASHB, and SBII; after adjusting for age, sex, and BMI, FIQ remained negatively associated with SBII. SASHB correlated with FIQ only in children <6 years, while OAHI showed no significant correlation. VIQ in younger children negatively correlated with SASHB/SBII, but only with OAHI in older children. PIQ in younger children correlated with OAHI, while no correlations existed in older children. P300 latency positively correlated with OAHI; other ERP parameters showed no associations.ConclusionOSA children demonstrate significant cognitive decline and ERP abnormalities. SASHB and SBII exhibit stronger correlations with cognitive impairment than OAHI, particularly in younger children, highlighting their potential as precise metrics for evaluating cognitive deficits in pediatric OSA.https://www.frontiersin.org/articles/10.3389/fped.2025.1628961/fullsleep apnea-specific hypoxic burdensleep breathing impairment indexchildren OSAcognition impairmentobstructive apnea-hypopnea index
spellingShingle Simin Zhu
Yanuo Zhou
Chendi Lu
Zitong Wang
Lina Ma
Xiaoxin Niu
Yushan Xie
Zihan Xia
Yonglong Su
Yuqi Yuan
Jiayi Yang
Rui Lu
Xinru Lv
Wei Hou
Yani Feng
Xiaoyong Ren
Yewen Shi
Effectiveness of the sleep apnea-specific hypoxic burden and sleep breathing impairment index in assessing cognitive impairment in children with obstructive sleep apnea
Frontiers in Pediatrics
sleep apnea-specific hypoxic burden
sleep breathing impairment index
children OSA
cognition impairment
obstructive apnea-hypopnea index
title Effectiveness of the sleep apnea-specific hypoxic burden and sleep breathing impairment index in assessing cognitive impairment in children with obstructive sleep apnea
title_full Effectiveness of the sleep apnea-specific hypoxic burden and sleep breathing impairment index in assessing cognitive impairment in children with obstructive sleep apnea
title_fullStr Effectiveness of the sleep apnea-specific hypoxic burden and sleep breathing impairment index in assessing cognitive impairment in children with obstructive sleep apnea
title_full_unstemmed Effectiveness of the sleep apnea-specific hypoxic burden and sleep breathing impairment index in assessing cognitive impairment in children with obstructive sleep apnea
title_short Effectiveness of the sleep apnea-specific hypoxic burden and sleep breathing impairment index in assessing cognitive impairment in children with obstructive sleep apnea
title_sort effectiveness of the sleep apnea specific hypoxic burden and sleep breathing impairment index in assessing cognitive impairment in children with obstructive sleep apnea
topic sleep apnea-specific hypoxic burden
sleep breathing impairment index
children OSA
cognition impairment
obstructive apnea-hypopnea index
url https://www.frontiersin.org/articles/10.3389/fped.2025.1628961/full
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