Sleep-disordered breathing symptoms are associated with poorer cognitive function in 5-year-old children

A Randomized Trial of Adenotonsillectomy for Childhood Sleep Apnea

“…30 Previous studies have shown differences in the cognitive function of children with the obstructive sleep apnea syndrome, as compared with controls. 19,27,31 However, baseline cognitive scores of children with the obstructive sleep apnea syndrome fell within the normal range, a finding similar to that in the current study. Cognitive and behavioral abnormalities have been shown to be reduced after adenotonsillectomy in some, [24][25][26][27]29 but not all, 30 nonrandomized studies, with inconsistency in the reported effect after treatment.…”

“…We calculated that with a sample of 400 children, randomly assigned in a 1:1 ratio to early adenotonsillectomy or a strategy of watchful waiting, the study would have 90% power to detect an effect size of 0.32 or more (on the basis of an estimate from one previous study 19 ) for the primary outcome. We planned to enroll 460 children to compensate for withdrawal from the study.…”

Sleep and Development in Genetically Tractable Model Organisms

“…A caveat to utilizing OSA as a means to study the impact of sleep fragmentation is the difficulty in distinguishing the effect of sleep loss from that of poor oxygenation or even obesity, which could independently impair developmental processes. However, snoring with sleep fragmentation in the absence of abnormal oxygenation also negatively affects multiple cognitive measures (Gottlieb et al 2004), lending credence to the hypothesis that sleep itself is of primary importance.…”

“…OSA in adults and children alike results in numerous complications, including cognitive dysfunction (Findley et al 1986;Gozal 1998;Beebe et al 2003;Archbold et al 2004). Indeed in children, sleep-disordered breathing has been associated with reduced cognitive function and general intelligence, as well as neuroimaging-based evidence for prefrontal cortical abnormalities (Schechter 2002;Gottlieb et al 2004;O'Brien et al 2004;Halbower et al 2006); severity of apnea also correlates with worsened neuropsychological deficits (O'Brien et al 2004). A caveat to utilizing OSA as a means to study the impact of sleep fragmentation is the difficulty in distinguishing the effect of sleep loss from that of poor oxygenation or even obesity, which could independently impair developmental processes.…”

How to detect Obstructive Sleep Apnea Syndrome (OSAS) in children

“…-a decrease in growth both in height and weight 25,62 , resulting from fragmentation of the profound deep sleep that, when undisturbed, promotes the release of growth hormones; -problems in waking behavior 1,2,8,10,16,19,20,30,31,34,44,49,52,53,54,68,70,72,73,76,83,88,93,94 with pseudo-hyperactivity and an increase in psychiatric problems; -difficulties in concentration and learning, interference with control of functional activity with a lowered scores on intelligence tests, and difficulties in classroom performance. It should be noted that there is a 6 to 9 times greater risk of OSAS in the 3 lowest ranked students in the class 34 ;…”