Executive dysfunction in children affected by obstructive sleep apnea syndrome: an observational study

Area of Science:

• Pediatric Sleep Medicine
• Neuropsychology
• Child Development

Background:

• Sleep is crucial for cognitive processes in children and adolescents.
• Disturbed sleep, particularly obstructive sleep apnea syndrome (OSAS), is linked to neuropsychological and behavioral issues.
• Executive functions (EF) are self-regulatory cognitive processes vital for goal-directed behavior.

Purpose of the Study:

• To assess the impact of obstructive sleep apnea syndrome (OSAS) on executive functions (EF) in school-aged children.
• To investigate the relationship between nocturnal respiratory parameters and EF deficits.

Main Methods:

• A cohort of 79 children with OSAS and 92 healthy children (aged 7-12 years) were studied.
• OSAS severity was evaluated via overnight respiratory monitoring.
• Executive functions were screened using the Modified Card Sorting Test, and daytime sleepiness was assessed with the Pediatric Daytime Sleepiness Scale (PDSS).

Main Results:

• Children with OSAS demonstrated significantly higher error rates (total, perseverative, non-perseverative) and lower performance in completed categories, correct sorts, and categorizing efficiency compared to controls.
• No significant differences were observed in age, gender, BMI, IQ, or PDSS scores between groups.
• A positive correlation was found between respiratory disturbance indices (e.g., apnea-hypopnea index) and error parameters, and a negative correlation with category completion.

Conclusions:

• This study highlights significant executive functioning deficits in children with OSAS.
• It is the first to report a correlation between nocturnal respiratory alterations and EF deficits in developmental age.
• These findings underscore the importance of addressing OSAS for cognitive health in children.