Neurobehavioral morbidity of pediatric mild sleep-disordered breathing and obstructive sleep apnea

Sleep

article

Yu, Phoebe K¹  Radcliffe, Jerilynn³  Gerry Taylor, H⁴  Amin, Raouf S⁵  Baldassari, Cristina M⁶  Boswick, Thomas⁶  Chervin, Ronald D⁷  Elden, Lisa M⁸  Furth, Susan L⁹  Garetz, Susan L^1,10  George, Alisha⁵  Ishman, Stacey L^1,11  Kirkham, Erin M^1,10  Liu, Christopher^1,13  Mitchell, Ron B^1,13  Kamal Naqvi, S^1,14  Rosen, Carol L⁴  Ross, Kristie R^1,15  Shah, Jay R^1,16  Tapia, Ignacio E⁹  Young, Lisa R⁹  Zopf, David A^1,10  Wang, Rui¹  Redline, Susan¹ 

[1] Brigham and Women’s Hospital, Division of Sleep and Circadian Disorders;Massachusetts Eye and Ear Infirmary, Department of Otolaryngology;Division of Developmental and Behavioral Pediatrics, Children’s Hospital of Philadelphia;Case Western Reserve University School of Medicine, Department of Pediatrics;Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, Cincinnati;Eastern Virginia Medical School, Department of Otolaryngology Head and Neck Surgery, Children’s Hospitals of The King’s Daughters Department of Pediatric Sleep Medicine;University of Michigan, Department of Neurology;Children’s Hospital of Philadelphia, Division of Otolaryngology;Children’s Hospital of Philadelphia, Department of Pediatrics, Division of Pulmonary and Sleep Medicine;University of Michigan, Department of Otolaryngology – Head and Neck Surgery;University of Cincinnati College of Medicine, Department of Otolaryngology – Head and Neck Surgery, Cincinnati;Cincinnati Children’s Hospital Medical Center, Division of Otolaryngology – Head & Neck Surgery, Cincinnati;University of Texas Southwestern, Department of Otolaryngology;University of Texas Southwestern, Department of Pediatrics;University Hospitals Rainbow Babies & Children’s Hospital, Department of Pediatrics;University Hospitals Rainbow Babies & Children’s Hospital, Department of Otolaryngology;Harvard T.H. Chan School of Public Health, Department of Epidemiology

关键词: pediatric;    sleep-disordered breathing;    obstructive sleep apnea;    behavior;    neurocognition;   

DOI  :  10.1093/sleep/zsac035

学科分类：生理学

来源: American Academy of Sleep Medicine

【 摘 要 】

Study Objectives Obstructive sleep apnea is associated with neurobehavioral dysfunction, but the relationship between disease severity as measured by the apnea-hypopnea index and neurobehavioral morbidity is unclear. The objective of our study is to compare the neurobehavioral morbidity of mild sleep-disordered breathing versus obstructive sleep apnea.Methods Children 3–12 years old recruited for mild sleep-disordered breathing (snoring with obstructive apnea-hypopnea index < 3) into the Pediatric Adenotonsillectomy Trial for Snoring were compared to children 5–9 years old recruited for obstructive sleep apnea (obstructive apnea-hypopnea 2–30) into the Childhood Adenotonsillectomy Trial. Baseline demographic, polysomnographic, and neurobehavioral outcomes were compared using univariable and multivariable analysis.Results The sample included 453 participants with obstructive sleep apnea (median obstructive apnea-hypopnea index 5.7) and 459 participants with mild sleep-disordered breathing (median obstructive apnea-hypopnea index 0.5). By polysomnography, participants with obstructive sleep apnea had poorer sleep efficiency and more arousals. Children with mild sleep-disordered breathing had more abnormal executive function scores (adjusted odds ratio 1.96, 95% CI 1.30–2.94) compared to children with obstructive sleep apnea. There were also elevated Conners scores for inattention (adjusted odds ratio 3.16, CI 1.98–5.02) and hyperactivity (adjusted odds ratio 2.82, CI 1.83–4.34) in children recruited for mild sleep-disordered breathing.Conclusions Abnormal executive function, inattention, and hyperactivity were more common in symptomatic children recruited into a trial for mild sleep-disordered breathing compared to children recruited into a trial for obstructive sleep apnea. Young, snoring children with only minimally elevated apnea-hypopnea levels may still be at risk for deficits in executive function and attention.

【 授权许可】

All Rights reserved