Effect of Sleep-Disordered Breathing Severity on Cognitive Performance Measures in a Large Community Cohort of Young School-Aged Children.

Hunter SJ, Gozal D, Smith DL, Philby MF, Kaylegian J, Kheirandish-Gozal L. Am J Respir Crit Care Med. 2016 Mar 1.

BACKGROUND AND OBJECTIVES: Sleep-disordered breathing (SDB) in children is associated with cognitive challenges. However, potential associations between SDB severity and neurocognitive functioning, and the presence of a SDB cut-off have not been fully explored.
METHODS: 1,010 5-to-7 year-old snoring and non-snoring children were prospectively recruited from public schools, underwent polysomnography and neurocognitive assessments of intellectual, attention, memory, language, and executive development. Children were subdivided into 4 severity groups based on AHI, followed by comparisons of cognitive functioning, particularly focusing on standardized subtests of intellectual, language, attention, memory, and executive functioning.
RESULTS: DAS Verbal (p < .001) and Nonverbal performance (p = .002), as well as Global Conceptual Ability (IQ) (p < .001) scores differed significantly across the groups, with higher AHI showing worse performance. Additionally, specific NEPSY sub-scores, focusing on attention and executive skills, differed across the groups, indicating differences in levels of engagement and problem solving. Children with higher AHI (> 5/hrTST) were significantly more impaired than all three lower AHI groups, indicating a dose-response impact of SDB.
CONCLUSIONS: This large community-based sample of children highlights the significant deleterious impact of SDB, particularly of moderate to severe OSA, and also that even snoring alone affects neurocognitive functioning. Affecting developing capabilities, as illustrated by cognitive measures, in a severity graded manner, SDB could adversely impact on children’s capacity to attain academic and adaptive goals, ultimately hampering their ability to reach independence. Our findings support the need for increased awareness with particular emphasis on children with more severe OSA.

Ventana Cientifica. Mayo 2016. Artículo 152
Effect of Sleep-Disordered Breathing Severity on Cognitive Performance Measures in a Large Community Cohort of Young School-Aged Children.