Sleep Cyclic Alternating Pattern in Otherwise Healthy Overweight School-Age Children

Abstract

Study Objectives: To compare sleep microstructure (cyclic alternating pattern, CAP) characteristics in otherwise healthy overweight (OW) and normal weight (NW) children Design: Polysomnographic cross-sectional study Setting: Sleep laboratory Participants: Fifty-eight (26 NW and 32 OW) 10-year-old children Interventions: N/A Measurements and Results: Participants were part of a longitudinal study beginning in infancy and free of sleep disorders. Groups were based on body-mass index (BMI) z-score. From polysomnographic overnight recordings, sleep-waking states were scored according to international criteria. CAP analysis was performed visually during NREM sleep. Conventional sleep parameters were similar between groups. BMI was positively related to CAP rate and CAP sequences but inversely related to CAP B phase duration. Differences between groups were confined to slow-wave sleep (SWS), with OW children showing higher CAP rate, CAP cycles, and CAP A1 number and index and shorter CAP cycles and B phase duration. They also showed more CAP class intervals shorter than 30 s, and a suggestive trend for fewer intervals longer than 30 s. Conclusions: Cyclic alternating pattern characteristics in children related to nutritional status and were altered in overweight subjects during slowwave sleep. We suggest that the more frequent oscillatory pattern of electroencephalographic slow activity in overweight subjects might reflect less stable slow-wave sleep episodes.