Sleep cyclic alternating pattern in normal school-age children

Oliviero Bruni, Raffaele Ferri, Silvia Miano, Elisabetta Verrillo, Elena Vittori, Giacomo Della Marca, Benedetto Farina, Gioacchino Mennuni

Research output: Contribution to journalArticlepeer-review


Objectives: To evaluate cyclic alternating pattern (CAP) in sleep of school-age children in order to obtain a standardized database for CAP parameters in this age range. Methods: CAP parameters were quantified in 10 normal healthy subjects (6 males and 4 females, mean age 8.3 years; range 6-10 years). All subjects underwent polysomnography recordings for two consecutive nights in a standard laboratory setting. Sleep data were stored on computer using a 16-channel polysomnography digital system. Sleep macrostructure was visually scored according to the criteria by Rechtschaffen and Kales (Brain Information Service/Brain Research Institute, University of California, Los Angeles, 1968); CAP was visually scored following the criteria by Terzano et al. (Sleep Med 2 (2001) 537). Results: CAP rate showed a progressive increase with the deepness of sleep, with high values during slow wave sleep (SWS). CAP time showed its longest duration during non-REM (NREM) sleep stage 2 (S2), followed by SWS and sleep stage 1 (S1). No differences across NREM sleep stages were found for CAP cycle and phase B mean duration; on the contrary, phase A showed longer duration during SWS than in S1 and S2. Phases A1 were the most numerous (84.45%) followed by A3 (9.14%) and by A2 (6.44%). The distribution of phases A subtypes across NREM stages showed significant differences for the A1 subtypes that occurred more frequently during SWS than in S2 and S1 (and during S2 than in S1). Subtypes A3 were more frequent during S1 than SWS while no differences were found for subtype A2. The analysis of A1 interval distribution showed a log-normal-like distribution with a peak around 25 s for the A1 phases and no clear peak for A2-A3 phases. Conclusions: The analysis of CAP in school-age children is characterized by an increase of CAP rate during SWS and a high percentage of A1 phases. The distribution of interval between consecutive A1 phases showed a peak around 25 s.

Original languageEnglish
Pages (from-to)1806-1814
Number of pages9
JournalClinical Neurophysiology
Issue number11
Publication statusPublished - Nov 2002


  • Arousal
  • Children
  • Cyclic alternating pattern
  • Polysomnography
  • Sleep

ASJC Scopus subject areas

  • Clinical Neurology
  • Physiology (medical)
  • Radiology Nuclear Medicine and imaging
  • Neurology
  • Sensory Systems


Dive into the research topics of 'Sleep cyclic alternating pattern in normal school-age children'. Together they form a unique fingerprint.

Cite this