Resting‐State Cerebral Hemodynamics is Associated With Problem Behaviors in Pediatric Sleep‐Disordered Breathing

Abstract

ObjectiveUntreated sleep‐disordered breathing (SDB) is associated with problem behaviors in children. The neurological basis for this relationship is unknown. We used functional near‐infrared spectroscopy (fNIRS) to assess the relationship between cerebral hemodynamics of the frontal lobe of the brain and problem behaviors in children with SDB.Study DesignCross‐sectional.SettingUrban tertiary care academic children's hospital and affiliated sleep center.MethodsWe enrolled children with SDB aged 5 to 16 years old referred for polysomnography. We measured fNIRS‐derived cerebral hemodynamics within the frontal lobe during polysomnography. We assessed parent‐reported problem behaviors using the Behavioral Response Inventory of Executive Function Second Edition (BRIEF‐2). We compared the relationships between (i) the instability in cerebral perfusion in the frontal lobe measured fNIRS, (ii) SDB severity using apnea‐hypopnea index (AHI), and (iii) BRIEF‐2 clinical scales using Pearson correlation (r). A p < .05 was considered significant.ResultsA total of 54 children were included. The average age was 7.8 (95% confidence interval, 7.0‐8.7) years; 26 (48%) were boys and 25 (46%) were Black. The mean AHI was 9.9 (5.7‐14.1). There is a statistically significant inverse relationship between the coefficient of variation of perfusion in the frontal lobe and BRIEF‐2 clinical scales (range of r = 0.24‐0.49, range of p = .076 to <.001). The correlations between AHI and BRIEF‐2 scales were not statistically significant.ConclusionThese results provide preliminary evidence for fNIRS as a child‐friendly biomarker for the assessment of adverse outcomes of SDB.