The most common sleep disorder in children, affecting over 1.5 million Australian children, is that of sleep disordered breathing, with the hallmark symptom of snoring. In children sleep disordered breathing is primarily due to enlarged tonsil and adenoid tissue. Sleep disordered breathing forms a spectrum of severity from simple or primary snoring, which is not associated with clinically significant oxygen desaturation or sleep fragmentation (using current techniques) to obstructive sleep apnoea. The apnoeas which are a feature of sleep disordered breathing are associated with repetitive falls in peripheral and cerebral oxygen saturation and the arousals which occur to terminate these events disrupt sleep. These two features are thought to underpin both the cardiovascular and neurocognitive consequences of the disorder. Our recent studies have examined the integrity of brain tissue with non-invasive diffusion tensor imaging in non-snoring control children and children with sleep disordered breathing. We have identified that sleep disordered breathing is accompanied by predominantly acute brain changes in areas that regulate autonomic, cognitive, and mood functions, and chronic changes in frontal cortices essential for behavioural control. This is the first time that these changes have been identified in children and likely result from the repetitive hypoxia falls in cerebral oxygenation that we have shown are associated with sleep disordered breathing. What we need to understand now is if these acute and chronic brain changes can be normalised following treatment and whether these changes are disease severity dependent.
obstructive sleep apnoea, MRI, children
Masters by research
Top-up scholarship funding available
Monash Medical Centre Clayton