Cerebral response to obstructive apnea: the times they are a-changin'

Excerpt

The response of the human brain to obstructive respiration during sleep is dynamic and is likely dependent on several different factors. The neural response, at least that measurable by surface electroencephalography (EEG), seems to be most in adults, less in children, and least in infants [1, 2]. This blunted arousal response to apnea in infants and children may act to protect the developing brain from the ill-effects of arousal. In this month's issue of Sleep and Breathing, Yang et al. further explore the arousal response of the childhood brain to obstructive respiratory events by using EEG spectral analysis [3]. The authors analyzed EEG before, during, and after respiratory events with spectral analysis, comparing events with and without association to EEG cortical arousal. While events associated with cortical arousal expectedly showed a decrease in delta and theta power, no such decrease was observed with events without obvious arousal. This study importantly confirms prior findings of decreased arousal response to apnea in the pediatric population. Furthermore, it provides reassurance that careful human scoring of EEG arousal is likely sufficient. …