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

Is there an association between cognitive impairment and urinary adrenaline, norepinephrine, gamma-aminobutyric acid, and taurine levels in children with obstructive sleep apnea?: A case control study

BACKGROUND

Children with obstructive sleep apnea (OSA) can develop cognitive impairments. Urinary adrenaline (EPI), norepinephrine (NE) and gamma-aminobutyric acid (GABA) are elevated, and taurine is decreased in children with OSA. The purpose of this study was to investigate the above-mentioned neurotransmitter levels in children with and without OSA, and explore their association with OSA-related cognitive impairments.

METHODS

Children underwent overnight polysomnography (PSG) for habitual snoring or mouth breathing in the pediatric sleep center from February 2023 to February 2024, as well as a group of healthy controls were enrolled in this study. Pediatric Quality of Life Inventory (PedsQL) and Child Behavior Checklist (CBCL) were used to evaluate the cognitive function of these children. Morning urine samples were collected to measure the urinary neurotransmitter levels.

RESULTS

This study recruited 74 children with OSA, 30 children with primary snoring (PS) and 16 healthy controls. In the comparison of PedsQL scores, social function (85(75, 100)), school function (65.88 ± 18.52), and total scores (74.15 ± 12.74) of OSA group were significantly lower than that of non-OSA group (P < 0.05); OSA group also exhibited increased withdrawn (1 (0, 2)) and attention problems (2 (1, 5)) scores in CBCL than non-OSA group (P < 0.05). A total of 39 cases in the OSA group (PedsQL total score below 77.42) were considered to have mild cognitive impairment (MCI), who had higher urinary EPI (190.68 ± 38.77 ng/ml) and lower taurine (432.20 ± 53.52 ng/ml) levels than both PS and OSA without MCI groups (P < 0.001). Logistic regression analysis showed that high levels of urinary NE (OR = 1.027, 95%CI: 1.002 ~ 1.052) and low levels of taurine (OR = 0.982, 95%CI: 0.969 ~ 0.995) are significantly associated with cognitive impairment in children with OSA, and their combination has a larger area under the curve (0.695) for prediction, with a sensitivity of 64.1% and specificity of 68.6% (P = 0.004).

CONCLUSIONS

Children with OSA presented impaired cognitive functions such as school, social function deficits and attention problems. Measuring urinary EPI and taurine levels may contribute to the prediction of OSA-related cognitive impairments.

Mind reading dysfunctions in patients with obstructive sleep apnoea: A neuropsychological approach

Obstructive sleep apnoea syndrome (OSAS) is a prevalent sleep-related breathing disorder that has been extensively studied for its effects on cognitive functions. However, little attention has been given to investigating Mind Reading (MR) skills in patients with OSAS. In this study, we employed a neuropsychological approach to thoroughly assess various facets of MR skills in patients with OSAS. Forty-two patients with untreated moderate or severe OSAS (AHI ≥15; 30 men, 12 women) and 16 healthy controls (7 men and 9 women), matched by age, were enrolled. To assess MR skills, we used: (i) The Story-based Empathy Task (SET), which includes three experimental conditions: identifying intentions (SET-IA), emotional states (SET-EA), and a control condition for inferring causality reactions (SET-CI); (ii) the Ekman 60 Faces Test (Ek60), which measures emotion recognition from facial expressions. Our findings revealed that patients with OSAS exhibit deficits in emotion-related MR skills, while their ability to make inferences about the cognitive states of social partners remains largely preserved. This finding corroborates previous evidence indicating that social cognition, particularly MR skills, may be one of the cognitive domains affected by OSAS. It emphasizes the significance of investigating social cognition and the relationship between MR skills and social functioning as a new and intriguing area of research in patients with OSAS.

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

Although we spend about one third of our life sleeping, the function and regulation of sleep remain scientific enigmas [...].