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Purpose: To analyze respiratory alterations and effects on SaO₂ caused by vagus nerve stimulation (VNS) in children with epilepsy.

Methods: Polysomnographic recordings, including electroencephalography, thoracoabdominal distention, nasal airflow, SaO₂, and VNS artifact were evaluated in 10 children with pharmacoresistant epilepsy treated with VNS.

Results: Each VNS caused a significant increase in respiratory frequency (p < 0.05) throughout the stimulation period and a decrease in thoracoabdominal‐distention amplitude (p < 0.05), especially at the beginning of the stimulation. These respiratory alterations induced a decrease in SaO₂ from 1 to 5%. The effects of VNS on respiration differed significantly between rapid‐eye‐movement (REM) and non‐REM (NREM) sleep states.

Conclusions: VNS caused a pronounced change in respiration in children with epilepsy, and this induced a decrease in SaO₂. It …