Working memory in children with sleep-disordered breathing: objective versus subjective measures

Area of Science:

• Pediatric Sleep Medicine
• Neuropsychology
• Child Development

Background:

• Parental reports frequently cite working memory deficits in children with sleep-disordered breathing (SDB).
• Objective testing results for these working memory deficits have been inconsistent.
• This discrepancy necessitates a closer examination of working memory performance across SDB severity levels.

Purpose of the Study:

• To compare working memory performance in children with varying degrees of SDB severity.
• To evaluate both parent-reported and objectively measured working memory function.
• To investigate the concordance between subjective and objective assessments of working memory in pediatric SDB.

Main Methods:

• 127 children (7-12 years) were classified into four groups via polysomnography: control, primary snoring (PS), mild obstructive sleep apnea (mild OSA), and moderate-to-severe OSA (MS OSA).
• Parental working memory was assessed using the Behavior Rating Inventory of Executive Function (BRIEF).
• Objective working memory was measured using a computerized card recognition task (CogHealth).

Main Results:

• Parental reports (BRIEF) indicated working memory deficits across all SDB severities compared to controls.
• Objective testing (CogHealth) showed no significant differences between SDB groups and controls, though mild OSA performed worse than PS.
• A notable discrepancy emerged: parents of controls reported fewer deficits, while parents of PS reported more deficits than objective measures indicated.

Conclusions:

• Parents of children with less severe SDB may overestimate working memory deficits, potentially reflecting behavioral observations rather than cognitive impairment.
• The assessment method significantly influences the observed working memory deficits in children with SDB.
• Children with SDB might not experience the extent of working memory impairment previously assumed, highlighting the importance of objective evaluation.