Trapped Between Fatigue and Feelings: How Paediatric OSAS Affects Physical Activity and Emotion Recognition

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ABSTRACT

Aim

To investigate emotion recognition abilities in paediatric patients affected by obstructive sleep apnea syndrome (OSAS) and explore related neurocognitive alterations.

Methods

Fifty children aged 6–11 years diagnosed with OSAS and 50 matched controls underwent polysomnography, emotion recognition testing (TEC), and physical activity monitoring. Neurocognitive assessments included analysis of brain morphology, EEG activity, and metabolic markers from previous literature.

Results

Children with OSAS showed impairments in emotion recognition linked to alterations in brain regions involved in emotional regulation, such as the prefrontal cortex and hippocampus. These changes correlated with neuroinflammation markers and disrupted brain connectivity. OSAS patients exhibited higher paroxysmal EEG activity and reduced local network efficiency. Cognitive scores (WISC) and gray matter volume were significantly lower in the OSAS group. Treatment may improve these deficits, possibly via BDNF regulation.

Conclusion

OSAS in children negatively impacts emotion recognition and neurocognitive functions due to brain structural and functional alterations. These findings support the need for early diagnosis and treatment to mitigate cognitive and emotional deficits associated with paediatric OSAS.

Statistics

Data normality was tested with Kolmogorov-Smirnov; group differences analyzed using Mann-Whitney U or Student’s t-tests. Categorical variables were examined with Chi-square or Fisher exact tests. Spearman correlation was used for associations. Statistical significance was set at p<0.05.

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