Sleep cyclic alternating pattern in normal school-age children

Bruni, Oliviero; Ferri, Raffaele; Miano, Silvia; Verrillo, Elisabetta; Vittori, Elena; Marca, Giacomo Della; Farina, Benedetto; Mennuni, G

doi:10.1016/s1388-2457(02)00265-1

Cited by 73 publications

(30 citation statements)

References 25 publications

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“…In comparison with published normative values [16], both LS patients showed significantly higher percentage of A1 phases (A1%). In both subjects A1% did not significant change during IGF-1 therapy or after wash-out (case 1 during IGF-1 therapy: 95.5%; case 1 in wash-out: 94.8%; case 2 during IGF-1 therapy: 94.0%; case 2 in wash-out: 94.1%; control subjects: mean 86.21%, –SD: 3.96).…”

Section: Resultsmentioning

confidence: 56%

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NREM Sleep Architecture and Relation to GH/IGF-1 Axis in Laron Syndrome

Verrillo

Bizzarri²,

Cappa³

et al. 2010

Horm Res Paediatr

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Background: Laron syndrome (LS), known as growth hormone (GH) receptor deficiency, is a rare form of inherited GH resistance. Sleep disorders were described as a common feature of adult LS patients, while no data are available in children. Bi-directional interactions between human sleep and the somatotropic system were previously described, mainly between slow wave sleep and the nocturnal GH surge. Aims: To analyze the sleep macro- and microstructure in LS and to evaluate the influence of substitutive insulin-like growth factor 1 (IGF-1) therapy on it. Methods: Two young LS females underwent polysomnography; the first study was performed during IGF-1 therapy, the second one after a 3-month wash-out period. Results: In both patients, the sleep macrostructure showed that time in bed, sleep period time, total sleep time, sleep efficiency and rapid eye movement (REM) percentage were all increased during wash-out. The sleep microstructure (cyclic alternating pattern: CAP) showed significantly higher EEG slow oscillations (A1%) in NREM sleep, both during IGF-1 therapy and wash-out. Conclusions: Sleep macrostructure in LS children is slightly affected by substitutive IGF-1 therapy. Sleep microstructure shows an increase of A1%, probably related to abnormally high hypothalamic GHRH secretion, due to GH insensitivity.

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Section: Resultsmentioning

confidence: 56%

“…Sleep macrostructure and microstructure parameters were compared with published data [15,16]. The differences between the two sleep studies (during IGF-1 therapy and at the end of wash-out) were analyzed in the single patient by the Z test.…”

Section: Methodsmentioning

confidence: 99%

NREM Sleep Architecture and Relation to GH/IGF-1 Axis in Laron Syndrome

Verrillo

Bizzarri²,

Cappa³

et al. 2010

Horm Res Paediatr

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“…Regarding the differences in sleep structure related to age, we selected an age-matched control group from our previously published database [23,24]. It included 20 normal healthy Caucasian children with no history of organic or mental illness and without neurological or psychiatric disabilities [10 males; mean age (±SD): 6.3 ± 2.5 years, range 2.11–10.4 years].…”

Section: Methodsmentioning

confidence: 99%

Sleep Characteristics in Children with Growth Hormone Deficiency

et al. 2011

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Background/Aims: Growth hormone (GH) is preferentially secreted during slow wave sleep and the interactions between human sleep and the somatotropic system are well documented, although only few studies have investigated the sleep EEG in children with GH deficiency (GHD). The aim of this study was to evaluate the sleep structure of children with dysregulation of the GH/insulin-like growth factor axis. Methods: Laboratory polysomnographic sleep recordings were obtained from 10 GHD children and 20 normal healthy age-matched children. The classical sleep parameters were evaluated together with sleep microstructure, by means of the cyclic alternating pattern (CAP), in GHD patients and compared to the control group. Results: GHD children showed a significant decrease in total sleep time, sleep efficiency, movement time and in non-rapid eye movement sleep stage 2. Although some indicators of sleep fragmentation were increased in GHD children, we found a general decrease in EEG arousability represented by a significant global decrease in the CAP rate, involving all CAP A phase subtypes. Conclusions: The analysis of sleep microstructure by means of CAP, in children with GHD, showed a reduction of transient EEG amplitude oscillations. Further studies are needed in order to better clarify whether GH therapy is able to modify sleep microstructure in GHD children, and the relationships between sleep microstructure, hormonal secretion and neurocognitive function in these patients.

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“…In pre-teenagers, the frontal lobe connections are not mature and the frontal electroencephalogram (EEG) leads show minimal additional cortical arousals only in snoring. Other parameters to measure cortical and subcortical arousals are being validated in children, including the rate of cycling of the alternating pattern (Bruni et al 2002).…”

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confidence: 99%

Influence of obstructive sleep apnea syndrome on cognition development in children

Ding

Liu

Zhang

2010

Biological Rhythm Research

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Obstructive sleep apnea syndrome (OSAS) was first described more than a century ago; however, OSAS in children was first described in 1976. OSAS is a common problem in children as in adults, with a prevalence of 1-3%. OSAS is becoming a substantial health risk in children and the under-diagnosed condition may lead to substantial morbidity if left untreated. Childhood OSAS could be associated with cognitive development, but the impact of OSAS on cognitive learning is unclear; it could be associated with cognitive and functional deficits. Recent evidence suggests the possibility of sustained cognitive impairment in children with OSAS. There is little published on this subject, and the aim of this review is to provide a synthesis of the current literature addressing the effects of OSAS on cognitive development in children.

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Sleep cyclic alternating pattern in normal school-age children

Cited by 73 publications

References 25 publications

NREM Sleep Architecture and Relation to GH/IGF-1 Axis in Laron Syndrome

NREM Sleep Architecture and Relation to GH/IGF-1 Axis in Laron Syndrome

Sleep Characteristics in Children with Growth Hormone Deficiency

Influence of obstructive sleep apnea syndrome on cognition development in children

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