Facial Emotion Recognition Deficit in Children with Moderate/Severe Obstructive Sleep Apnea

Abstract

Although previous studies have reported a facial expression classification deficit among adults with SDB, we do not know whether these findings can be generalized to children. In our study, children with sleep-disordered breathing (SDB) were divided into three groups: primary snoring (n = 51), mild obstructive sleep apnea (OSA) (n = 39), and moderate/severe OSA (n = 26). All participants, including 20 healthy controls, underwent an overnight polysomnography recording and the Emotional Expression Recognition Task. Psychosocial problems were evaluated using the parent-reported Strengths and Difficulties Questionnaire (SDQ). There was a borderline significant interaction between expression category and group on reaction times. Further analysis revealed that positive classification advantage (PCA) disappeared in the moderate/severe OSA group, whereas it persisted in the control, primary snoring, and mild OSA groups. Emotional symptoms were positively correlated with OAHI. In both the happy and sad conditions, RT was negatively related to age and body mass index (BMI) but was independent of the obstructive apnea-hypopnea index (OAHI), arterial oxygen (SaO2) and total sleep time. The accuracy of identifying a sad expression was negatively related to conduct problems. Children with moderate/severe OSA exhibited dysfunction in facial expression categorization, which could potentially affect social communication ability.

The Mechanisms of Sleep Function and Regulation for Health and Cognitive Performance

“…This exploratory study revealed that children with RSD were mainly affected in selective attention, cognitive flexibility, and inhibitory control, in addition to daytime impairment, providing useful information for the clinicians. In the second study [7], children with different types (i.e., primary snoring, mild obstructive sleep apnea, and moderate/severe obstructive sleep apnea) of sleep-disordered breathing (SDB) were requested to perform an emotional expression recognition task. The authors found that children with moderate/severe obstructive sleep apnea tended to exhibit problems in facial expression categorization, with a possible impact in their social communication ability.…”