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Measuring Neural Mechanisms Underlying Sleep-Dependent Memory Consolidation During Naps in Early Childhood
Published on: October 2, 2019
Symptoms at presentation in children with sleep-related disorders
Katja Liukkonen1, Paula Virkkula, Anu Haavisto
1Department of Otorhinolaryngology and Head and Neck Surgery, Helsinki University Central Hospital and University of Helsinki, Finland. katja.liukkonen@hus.fi
Insights
Snoring children, even without major sleep-disordered breathing, show impaired cognitive and behavioral functions. These findings highlight the impact of snoring on child development and well-being.
Area of Science:
- Pediatric Sleep Medicine
- Neurodevelopmental Pediatrics
- Otolaryngology
Background:
- Sleep-disordered breathing (SDB) is increasingly linked to cognitive and behavioral issues in children.
- Snoring is a common symptom that may indicate underlying airway obstruction or SDB.
- The relationship between snoring, mild SDB, and neurocognitive function requires further investigation.
Purpose of the Study:
- To evaluate the association between snoring and cognitive function in children.
- To explore correlations between polysomnography (PSG) findings, upper respiratory infections (URIs), and cephalometric/rhinometric measures in snorers.
Main Methods:
- A population-based cohort study involving 2100 children, with 44 snorers and 51 non-snorers undergoing PSG, cephalometry, and rhinometry.
- Neurocognitive assessment included intelligence testing (WPPSI-R), a neuropsychological battery (NEPSY), and behavioral symptom questionnaires (CBCL).
Main Results:
- Snorers exhibited lower language function scores and more internalizing behavioral problems compared to non-snorers (P<0.05).
- PSG parameters showed poor correlation with neurocognitive test results in this cohort.
- Recurrent URIs were more prevalent in snorers (P=0.01) and associated with more somatic complaints.
Conclusions:
- Children who snore, even without significant SDB indicators on PSG, demonstrate neurocognitive and behavioral impairments.
- Mild airway narrowing, as indicated by cephalometry, was observed in snorers.
- The study suggests that snoring itself, independent of severe SDB, may negatively impact children's development.
Objective:
To assess the link between sleep-disordered breathing and cognitive function in children. To identify correlations among polysomnography, upper respiratory infections, or cephalometric as well as rhinometric measures.
Methods:
This study is based on a questionnaire survey of snoring in a population cohort of 2100 children. Altogether, 44 snorers and 51 non-snorers participated in this community based clinical study. All children underwent polysomnography, cephalometry and rhinometric measurements. In addition, a standardized test of intelligence (WPPSI-R), a neuropsychological test battery (NEPSY) and a parental questionnaire on behavioral symptoms (CBCL) were administered.
Results:
Frequently snoring children scored lower in Language functions (Comprehension of Instructions, P=0.01; Speeded naming, P=0.007) and had more internalizing problems, P=0.04 than did the non-snoring group. However, the polysomnography parameters of these snoring children revealed no major sleep-related breathing disorder. OAHI, mean lowest SpO(2) and respiratory effort correlated with Auditory Attention (P<0.05), Body Part Naming (P<0.05) and Memory (P<0.05). Tonsillar size correlated with OAHI (P<0.01) and respiratory effort (P=0.01) and respiratory airflow (P<0.01). In cephalometry, the minimal distance from velum to posterior wall was shorter showing the shorter length among snorers than non-snorers, 5.5mm vs. 6.6mm, respectively (P<0.05). Recurrent upper respirataory infections (URIs) were common among the snoring than non-snoring children (P=0.01). Children suffering recurrent URIs have more somatic complaints than children without recurrent URIs (P<0.01).
Conclusions:
Snoring children with apparently normal and/or no obstructive apnea, hypopnea, or marked SpO(2) desaturations appear to suffer impairment in neurocognitive and behavioral functions compared to non-snoring children. These snoring children did not reveal any major abnormalities of polysomnographic parameters, such as sleep-related breathing disorder, including partial upper airway obstruction. Polysomnographic parameters also correlated poorly with neurocognitive test results in these snoring children. The correlations between polysomnography and upper respiratory infections, with cephalometric and rhinometric measures, were also poor.
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