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Neurocognitive assessment and sleep analysis in children with sleep-disordered breathing

Silvia Miano1, Maria Chiara Paolino, Antonella Urbano

  • 1Department of Paediatrics, Sleep Disease Centre, La Sapienza University of Rome - Sant'Andrea Hospital, Rome, Italy.

Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology
|July 20, 2010
PubMed

Insights

Children with sleep-disordered breathing (SDB) show lower intelligence quotient (IQ) and higher attention deficit hyperactivity disorder (ADHD) scores. Sleep fragmentation, indicated by arousal, may help preserve cognitive function.

Area of Science:

  • Pediatric Sleep Medicine
  • Neurocognition
  • Respiratory Medicine

Background:

  • Sleep-disordered breathing (SDB) encompasses conditions like primary snoring and obstructive sleep apnea syndrome (OSAS).
  • SDB is associated with neurocognitive deficits, including lower intelligence quotient (IQ) and attention deficit hyperactivity disorder (ADHD) symptoms.
  • The relationship between sleep fragmentation, respiratory disturbances, and cognitive function in children with SDB requires further elucidation.

Purpose of the Study:

  • To investigate correlations between IQ, ADHD symptom severity, and polysomnographic sleep parameters (including cyclic alternating patterns) in children with SDB.
  • To compare neurocognitive and sleep characteristics of children with SDB to healthy controls.
  • To explore the role of sleep arousal as a potential compensatory mechanism for cognitive function during SDB events.

Main Methods:

  • A cohort of children with primary snoring (n=13) and OSAS (n=31) underwent polysomnography and neurocognitive assessments.
  • A control group of 60 healthy children from schools underwent neurocognitive assessments.
  • IQ and ADHD rating scales were administered, alongside detailed sleep analysis including cyclic alternating patterns (CAPs) and respiratory parameters.

Main Results:

  • Children with SDB exhibited lower IQ estimates and higher ADHD rating scale scores compared to controls.
  • OSAS patients showed increased REM sleep latency, higher arousal index, and reduced N3 and A mean duration.
  • Positive correlations were observed between global intelligence and wakefulness after sleep onset, N1, A2, arousal index, and A2 index in the SDB group.
  • Total and hyperactivity ADHD scores correlated positively with the A2 index.
  • Hyperactivity scores negatively correlated with nocturnal oxygen saturation.

Conclusions:

  • Arousal during sleep may act as a protective mechanism to preserve cognitive function despite respiratory disturbances in SDB.
  • This compensatory arousal comes at the cost of disrupted sleep maintenance and NREM sleep instability.
  • The findings highlight the significant impact of sleep fragmentation due to SDB on cognitive performance in children.
Abstract

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