Sleep-disordered breathing has a serious deleterious impact on children with moderate to severe obstructive sleep apnea, data from a large community-based study indicate.
The condition can ultimately have a negative impact on academic achievement and skill development, with outcomes worsened based on severity.
In order to see if a severity cut-off exists, in which deficits would be significantly increased, researchers led by Leila Kheirandish-Gozal, MD, the director of clinical sleep research in pediatric sleep medicine at the University of Chicago, conducted a prospective study of 1359 children aged 5-7 years. Comprehensive sleep assessments included questionnaires, overnight polysomnography, a neurocognitive testing to assess intellectual, attention, memory, language, and executive development.
Participants were ultimately divided into 4 groups based on severity of their sleep-disordered breathing: Group 1: Non Snoring, Apnea-Hypopnea Index (AHI) <1/ hour of total sleep time (hrTST); Group 2: Habitual Snoring, AHI<1/hrTST; Group 3: Habitual Snoring and AHI>1 and <5/hrTST; and Group 4: Habitual Snoring and AHI>5/hrTST. Cognitive function was also compared across all groups.
Notably, the DAS Verbal and Nonverbal performance and Global Conceptual Ability scores were significantly different across all 4 groups. Sub-scores focused on attention and executive skills also differed across groups, suggesting a variance in levels of engagement and problem solving. Participants with higher AHI (>5/hrTST) were more impaired than all other groups, indicated a dose-response impact for sleep-disordered breathing. The researchers also noted that the severity of sleep fragmentation and hypoxemia also contributed to variations in cognitive function.
As expected, the researchers found that sleep-disordered breathing has a serious affect on cognitive function, but surprisingly snoring alone also has an impact.
“Our findings support the need for early intervention, with a particular emphasis on those children with more severe OSA,” the authors concluded.
Kheirandish-Gozal L, Hunter SJ, Smith DL, Philby MF, Kaylegian J, Gozal D. Abstract A4325. Sleep-Disordered Breathing Severity and Cognitive Performance in Community Young School-Aged Children. Presented at: ATS 2016. May 13-18, 2016; San Francisco, Calif.