Sleep apnea severity, learning challenges linked in children

Sleep-disordered breathing adversely affects children’s capacity to attain academic and adaptive goals, and children with more severe symptoms are impacted the most, according to data presented at the American Thoracic Society Conference.

According to the researchers, the findings support the need for early intervention, with an emphasis on children with more severe obstructive sleep apnea.

Although evidence suggesting the presence of cognitive deficits in children with sleep apnea has been around for quite some time, the relatively small groups studied made it difficult to demonstrate a strong relationship between increasing cognitive issues and increasing sleep apnea severity,” Leila Gozal, MD, MSc, of the University of Chicago, said in a press release.

Gozal and colleagues examined a large pediatric population to evaluate effects of sleep-disordered breathing and cognitive function and to determine whether risk for learning challenges increased with more severe sleep-disordered breathing. They recruited 1,359 children aged 5 to 7 years from public schools and all children underwent a comprehensive sleep assessment.

Participants were divided into four categories, based on SDB severity: group 1, nonsnoring (Apnea-hypopnea index [AHI] < 1/hourTST); group 2, habitual snoring (AHI < 1/hourTST); group 3, habitual snoring and AHI > 1 and < 5/hourTST; and group 4, habitual snoring and AHI > 5/hourTST. Sleep assessments were completed through questionnaires and overnight polysomnography. In addition, researchers measured neurocognitive status in terms of intellectual, attention, memory, language and executive development.

According to the researchers, both verbal (P < .001) and nonverbal (P = .002) intellectual functioning performance, and Global Conceptual Ability (P < .001) scores, varied significantly across the four groups. Attention and executive functioning subscores also differed across groups. Those with higher AHI were significantly more impaired than all three lower AHI groups, according to the researchers. In addition, both the severity of sleep fragmentation and hypoxemia contributed to cognitive function variance.

“Our findings provide further justification for exploration and development of simple cognitive batteries that can be coupled to the current evaluation of children with habitual snoring such as to better guide the management of the decision-making process,” Gozal said in a press release. – by Jason Laday

Disclosure: Healio Family Medicine could not confirm the researchers’ relevant financial disclosures.

Reference:

Gozal L, et al. Sleep-disordered breathing severity and cognitive performance in community young school-aged children. Presented at: American Thoracic Society International Conference, May 13-18, 2016; San Francisco.