Cerebral blood flow response to hypercapnia in children with obstructive sleep apnea syndrome

David R. Busch, Jennifer M. Lynch, Madeline E. Winters, Ann L. McCarthy, John J. Newland, Tiffany Ko, Mary Anne Cornaglia, Jerilynn Radcliffe, Joseph M. McDonough, John Samuel, Edward Matthews, Rui Xiao, Arjun G. Yodh, Carole L. Marcus, Daniel J. Licht, Ignacio E. Tapia

Research output: Contribution to journalArticlepeer-review

25 Scopus citations


Study Objectives: Children with obstructive sleep apnea syndrome (OSAS) often experience periods of hypercapnia during sleep, a potent stimulator of cerebral blood flow (CBF). Considering this hypercapnia exposure during sleep, it is possible that children with OSAS have abnormal CBF responses to hypercapnia even during wakefulness. Therefore, we hypothesized that children with OSAS have blunted CBF response to hypercapnia during wakefulness, compared to snorers and controls. Methods: CBF changes during hypercapnic ventilatory response (HCVR) were tested in children with OSAS, snorers, and healthy controls using diffuse correlation spectroscopy (DCS). Peak CBF changes with respect to pre-hypercapnic baseline were measured for each group. The study was conducted at an academic pediatric sleep center. Results: Twelve children with OSAS (aged 10.1 ± 2.5 [mean ± standard deviation] y, obstructive apnea hypopnea index [AHI] = 9.4 [5.1-15.4] [median, interquartile range] events/hour), eight snorers (11 ± 3 y, 0.5 [0-1.3] events/hour), and 10 controls (11.4 ± 2.6 y, 0.3 [0.2-0.4] events/hour) were studied. The fractional CBF change during hypercapnia, normalized to the change in end-tidal carbon dioxide, was significantly higher in controls (9 ± 1.8 %/mmHg) compared to OSAS (7.1 ± 1.5, P = 0.023) and snorers (6.7 ± 1.9, P = 0.025). Conclusions: Children with OSAS and snorers have blunted CBF response to hypercapnia during wakefulness compared to controls. Noninvasive DCS blood flow measurements of hypercapnic reactivity offer insights into physiopathology of OSAS in children, which could lead to further understanding about the central nervous system complications of OSAS.

Original languageEnglish (US)
Pages (from-to)209-216
Number of pages8
Issue number1
StatePublished - 2016
Externally publishedYes


  • Cerebral blood flow
  • Child
  • Humans
  • Hypercapnia
  • Obstructive
  • Sleep apnea

ASJC Scopus subject areas

  • Clinical Neurology
  • Physiology (medical)


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