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Published on: December 6, 2016
Adenotonsillectomy improves neurocognitive function in children with obstructive sleep apnea syndrome
Bat-Chen Friedman1, Ayelet Hendeles-Amitai, Ely Kozminsky
1Department of Pediatrics B, Faculty of Health Sciences, Sleep-Wake Disorders Unit, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Insights
Children with obstructive sleep apnea syndrome (OSAS) experience impaired neurocognitive function. Adenotonsillectomy significantly improves these functions, often restoring them to healthy control levels within months.
Area of Science:
- Pediatric Sleep Medicine
- Neuropsychology
- Otolaryngology
Background:
- Obstructive sleep apnea syndrome (OSAS) is increasingly recognized in children.
- The impact of OSAS on pediatric neurocognitive development requires further elucidation.
- Adenotonsillectomy is a primary treatment for pediatric OSAS.
Purpose of the Study:
- To assess neurocognitive function in children with OSAS before and after adenotonsillectomy.
- To compare neurocognitive performance between children with OSAS and healthy controls.
- To determine the reversibility of neurocognitive deficits following treatment.
Main Methods:
- Prospective study design.
- Inclusion of 39 children with OSAS (ages 5-9) and 20 healthy controls.
- Utilized the Kaufman Assessment Battery for Children (K-ABC) for neurocognitive testing, with follow-up at 6-10 months post-adenotonsillectomy.
Main Results:
- Children with OSAS exhibited lower neurocognitive scores compared to controls, particularly in K-ABC subtests and the Mental Processing Composite.
- No correlation was found between OSAS severity and neurocognitive deficits.
- Post-adenotonsillectomy, OSAS children showed significant improvements in sleep, behavior, and neurocognitive performance, reaching control group levels in several K-ABC scales.
Conclusions:
- Pediatric OSAS is associated with reversible neurocognitive impairments.
- Adenotonsillectomy effectively improves neurocognitive function in children with OSAS.
- Most neurocognitive deficits resolve within 3-10 months after adenotonsillectomy, suggesting a high degree of reversibility.
Objective:
To evaluate neurocognitive functions of children with obstructive sleep apnea syndrome (OSAS), before and after adenotonsillectomy, compared with healthy controls.
Design:
Prospective study.
Patients And Methods:
Thirty-nine children with OSAS aged 5 to 9 years (mean age, 6.8 +/- 0.2 years) and 20 healthy children (mean age, 7.4 +/- 1.4 years) who served as controls, underwent a battery of neurocognitive tests containing process-oriented intelligence scales. Twenty-seven children in the OSAS group underwent follow-up neurocognitive testing 6 to 10 months after adenotonsillectomy. Fourteen children in the control group were also reevaluated 6 to 10 months after the first evaluation.
Results:
Children with OSAS had lower scores compared with healthy children in some Kaufman Assessment Battery for Children (K-ABC) subtests and in the general scale Mental Processing Composite, indicating impaired neurocognitive function. No correlation was found between neurocognitive performance and OSAS severity. Six to 10 months after adenotonsillectomy, the children with OSAS demonstrated significant improvement in sleep characteristics, as well as in daytime behavior. Their neurocognitive performance improved considerably, reaching the level of the control group in the subtests Gestalt Closure, Triangles, Word Order, and the Matrix analogies, as well as in the K-ABC general scales, Sequential and Simultaneous Processing scales, and the Mental Processing Composite scale. The magnitude of the change expressed as effect sizes showed medium and large improvements in all 3 general scales of the K-ABC tests.
Conclusions:
Neurocognitive function is impaired in otherwise healthy children with OSAS. Most functions improve to the level of the control group, indicating that the impaired neurocognitive functions are mostly reversible, at least 3 to 10 months following adenotonsillectomy.
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