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Sleep disordered breathing as measured by SRBD-PSQ and neurocognition in children with hypertension
Marc B Lande1, Stephen R Hooper2, Donald L Batisky3
1Department of Pediatrics, University of Rochester, Rochester, New York, USA; Marc_lande@urmc.rochester.edu.
Insights
Children with hypertension (HTN) show higher rates of sleep disordered breathing (SDB), which is linked to cognitive issues. This study investigated the SDB-cognition link in hypertensive children, finding SDB scores correlated with behavioral and mood problems.
Area of Science:
- Pediatric Neurology
- Sleep Medicine
- Cardiovascular Health
Background:
- Hypertension (HTN) in children is associated with cognitive deficits, potentially indicating early brain damage.
- Obesity is common in hypertensive children and linked to sleep disordered breathing (SDB), which can affect cognition.
- SDB may confound the relationship between HTN and neurocognition in pediatric populations.
Purpose of the Study:
- To examine the association between sleep disordered breathing (SDB), measured by a questionnaire, and neurocognition in children with hypertension.
- To assess SDB prevalence and its impact on cognitive function and behavioral outcomes in hypertensive children.
Main Methods:
- Participants underwent laboratory-based neurocognitive testing.
- Parents and children completed rating scales for executive function, mood, and behavior.
- The Sleep-Related Breathing Disorder scale of the Pediatric Sleep Questionnaire (SRBD-PSQ) was administered to parents.
Main Results:
- A significantly higher percentage of hypertensive children (26%) had SRBD-PSQ scores suggestive of obstructive sleep apnea compared to controls (6%).
- Higher SRBD-PSQ scores were not significantly linked to poorer performance on objective cognitive tests.
- Elevated SRBD-PSQ scores were significantly associated with worse parent/child-reported executive function, mood, and behavior problems.
Conclusions:
- Children with hypertension exhibit a greater prevalence of SDB indicators.
- The findings highlight the necessity of multi-method cognitive assessments in hypertensive children.
- Adjusting for SDB is crucial when studying cognition in pediatric hypertension to mitigate confounding effects.
Background:
Cognitive test performance is decreased in hypertensive adults and children, a finding postulated to represent early target-organ damage to the brain. Hypertensive children are often obese, a comorbidity associated with sleep disordered breathing (SDB), itself associated with cognitive problems; potentially confounding the relation between hypertension (HTN) and neurocognition. Our objective was to determine the association between SDB as measured by a scale and questionnaire score and neurocognition among participants enrolled in an ongoing multicenter study of cognition in children with HTN.
Methods:
Subjects completed laboratory-based neurocognitive tests. Parents and subjects completed rating scales of executive function, mood, and behavior problems. Parents completed the Sleep-Related Breathing Disorder scale of the Pediatric Sleep Questionnaire (SRBD-PSQ).
Results:
To date, 38 HTN subjects and 34 control subjects have completed neurocognitive testing and the SRBD-PSQ. Median SRBD-PSQ scores were similar between groups but the HTN group had a higher percentage of subjects with SRBD-PSQ scores in the range suggestive of obstructive sleep apnea (26% vs. 6%, P = 0.03). Overall, higher SRBD-PSQ scores were not significantly associated with worse performance on laboratory-based measures of executive function and other cognitive domains but were significantly associated with worse scores on rating scales of executive function as well as mood and behavior problems.
Conclusions:
A larger proportion of children with HTN had scores suggestive of SDB. The results underscore the importance of using a multi-method approach in the assessment of cognition and adjusting for potential confounding effects of SDB in studies of cognition in hypertensive children.
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