Neurobehavioral Morbidity of Pediatric Mild Sleep-disordered Breathing and Obstructive Sleep Apnea

Overview

Journal Sleep

Publisher Oxford University Press

Specialty Psychiatry

Date 2022 May 13

PMID 35554583

Authors

Phoebe K Yu

Jerilynn Radcliffe

H Gerry Taylor

Raouf S Amin

Cristina M Baldassari

Thomas Boswick

Ronald D Chervin

Lisa M Elden

Susan L Furth

Susan L Garetz

Alisha George

Stacey L Ishman

Erin M Kirkham

Christopher Liu

Ron B Mitchell

S Kamal Naqvi

Carol L Rosen

Kristie R Ross

Jay R Shah

Ignacio E Tapia

Lisa R Young

David A Zopf

Rui Wang

Susan Redline

Affiliations

Soon will be listed here.

Abstract

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.

Trial Registration: Pediatric Adenotonsillectomy for Snoring (PATS), NCT02562040; Childhood Adenotonsillectomy Trial (CHAT), NCT00560859.

Citing Articles

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