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Behavior and neurocognitive performance in children aged 5-10 years who snore compared to controls
S Blunden1, K Lushington, D Kennedy
1School of Psychology, University of South Australia, Australia.
Insights
Even mild sleep disordered breathing, like primary snoring in children, can negatively impact attention and cognitive function. This suggests early intervention is crucial for academic and developmental progress.
Area of Science:
- Pediatric Sleep Medicine
- Neurodevelopmental Pediatrics
- Child Psychology
Background:
- Sleep disordered breathing (SDB) in children, including primary snoring and obstructive sleep apnea syndrome (OSAS), is prevalent yet often underdiagnosed.
- While severe OSAS is linked to cognitive deficits, the effects of milder forms of SDB on neurocognition remain less understood.
- Children referred for snoring evaluation often present with primary snoring or very mild OSAS.
Purpose of the Study:
- To investigate the neurocognitive and behavioral differences between children who snore (with or without mild SDB) and non-snoring controls.
- To assess the impact of primary snoring and very mild OSAS on attention, memory, intelligence, social competency, and behavior.
- To determine if mild SDB affects daytime functioning in children.
Main Methods:
- A case-control study involving 16 children referred for snoring and 16 age-matched non-snoring controls (5-10 years).
- Overnight polysomnography (PSG) was performed to diagnose primary snoring and very mild OSAS.
- Neurocognitive and behavioral assessments included measures of intelligence, memory, attention, social competency, and problematic behavior.
Main Results:
- Children who snored exhibited significantly impaired attention compared to controls.
- Snoring children also showed lower scores in memory and intelligence, though still within the normal range.
- No significant differences were found in social competency or problematic behavior between the groups.
Conclusions:
- Snoring in children, even without severe OSAS, is associated with reduced neurocognitive performance, particularly in attention.
- Mild sleep disordered breathing may have a more substantial impact on daytime functioning than previously recognized.
- These findings highlight the importance of addressing snoring in children to support academic success and overall development.
Abstract:
Sleep disordered breathing in children is a common but largely underdiagnosed problem. It ranges in severity from primary snoring to obstructive sleep apnea syndrome (OSAS). Preliminary evidence suggests that children with severe OSAS show reduced neurocognitive performance, however, less is known about children who snore but do not have severe upper airway obstruction. Participants included 16 children referred to the Ear, Nose and Throat/Respiratory departments of a Children's Hospital for evaluation of snoring and 16 non-snoring controls aged 5-10 years. Overnight polysomnography (PSG) was carried out in 13 children who snored and 13 controls. The PSG confirmed the presence of primary snoring in seven and very mild OSAS (as evidenced by chest wall paradox) in eight children referred for snoring while controls showed a normal sleep pattern. To test for group differences in neurocognitive functioning and behavior, children underwent one day of testing during which measures of intelligence, memory, attention, social competency, and problematic behavior were collected. Compared to controls, children who snored showed significantly impaired attention and, although within the normal range, lower memory and intelligence scores. No significant group differences were observed for social competency and problematic behavior. These findings suggest that neurocognitive performance is reduced in children who snore but are otherwise healthy and who do not have severe OSAS. They further imply that the impact of mild sleep disordered breathing on daytime functioning may be more significant than previously realized with subsequent implications for successful academic and developmental progress.