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Long-Term Neurophysiologic Impact of Childhood Sleep Disordered Breathing on Neurocognitive Performance
Stuart F Quan1, Kristen Archbold2, Alan S Gevins3
1Arizona Respiratory Center, University of Arizona College of Medicine, Tucson, AZ ; Division of Sleep Medicine, Harvard Medical School, Boston, MA.
Insights
Children with sleep disordered breathing (SDB) show subtle long-term neurocognitive changes. These effects on executive function are detectable with electrophysiologic monitoring, not standard tests.
Area of Science:
- Pediatric Neurology
- Sleep Medicine
- Neuropsychology
Background:
- Sleep disordered breathing (SDB) is prevalent in children.
- Long-term neurocognitive consequences of pediatric SDB require further investigation.
Purpose of the Study:
- To assess the impact of childhood SDB on neurocognitive function 5 years post-diagnosis.
- To identify potential subtle deficits not captured by conventional testing.
Main Methods:
- A longitudinal study matched 43 children with SDB to 43 controls (ages 6-11 at baseline).
- Neurocognitive function was assessed using the Sustained Working Memory Task (SWMT) and electroencephalography (EEG) approximately 5 years later.
Main Results:
- No significant differences were found in standard neurocognitive test performance between SDB and control groups.
- The SDB group showed reduced P300 amplitudes during reaction time and attention tasks.
- Lower peak alpha power was observed in the SDB group during attention tasks.
Conclusions:
- Pediatric SDB may lead to subtle, long-term executive function changes.
- These subtle deficits are not apparent with conventional neurocognitive assessments.
- Neuroelectrophysiologic monitoring is crucial for detecting SDB-related neurocognitive alterations.
Study Objective:
To determine the impact of sleep disordered breathing (SDB) in children on neurocognitive function 5 years later.
Design Setting And Participants:
A subgroup of 43 children from the Tucson Children's Assessment of Sleep Apnea Study (TuCASA) who had SDB (RDI ≥ 6 events/hour) at their initial exam (ages 6-11 years) were matched on the basis of age (within 1 year), gender and ethnicity (Anglo/Hispanic) to 43 children without SDB (Control, RDI ≤ 4 events/hour). The Sustained Working Memory Task (SWMT) which combines tests of working memory (1-Back Task), reaction time (Simple Reaction Time) and attention (Multiplexing Task) with concurrent electroencephalographic monitoring was administered approximately 5 years later.
Results:
There were no differences in performance on the working memory, reaction time and attention tests between the SDB and Control groups. However, the SDB group exhibited lower P300 evoked potential amplitudes during the Simple Reaction Time and Multiplexing Tasks. Additionally, peak alpha power during the Multiplexing Task was lower in the SDB Group with a similar trend in the Simple Reaction Time Task (p=0.08).
Conclusions:
SDB in children may cause subtle long-term changes in executive function that are not detectable with conventional neurocognitive testing and are only evident during neuroelectrophysiologic monitoring.
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