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Hearing loss mediates executive function impairment in sleep-disordered breathing.

Catherine M Hill1, Romola S Bucks2, Colin R Kennedy3

  • 1Division of Clinical Experimental Sciences, Faculty of Medicine, University of Southampton, UK; Southampton Children's Hospital, Southampton, UK.

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PubMed
Summary

Conductive hearing loss in young children with sleep-disordered breathing (SDB) impacts executive function, but not behavior. Addressing hearing loss in preschool SDB may improve executive function outcomes.

Keywords:
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Area of Science:

  • Pediatric Otolaryngology
  • Pediatric Sleep Medicine
  • Developmental Psychology

Background:

  • Sleep-disordered breathing (SDB) and conductive hearing loss frequently co-occur in early childhood, often due to adenotonsillar hypertrophy.
  • Conductive hearing loss is independently linked to impaired executive function and behavioral issues in children.
  • This study investigated if hearing loss mediates executive function and behavioral deficits in children with SDB.

Purpose of the Study:

  • To examine the relationship between SDB and executive function/behavioral difficulties in preschool children.
  • To determine if conductive hearing loss mediates these impairments in children with SDB.
  • To explore potential therapeutic targets for improving outcomes in children with SDB.

Main Methods:

  • Fifty-eight children (3-5 years) were assessed: 37 snorers awaiting adenotonsillectomy and 21 controls.
  • Evaluations included audiometry, Strengths and Difficulties Questionnaire (SDQ), Behavior Rating of Executive Function (BRIEF-P), and hearing questionnaires.
  • Polysomnography identified obstructive sleep apnea (OSA) in snorers; regression models analyzed SDB, hearing loss, and outcomes.

Main Results:

  • Snorers exhibited poorer hearing, greater past hearing loss exposure, and higher SDQ/BRIEF-P scores than controls.
  • Hearing loss history, not same-day audiometry, fully mediated snoring's impact on executive function (BRIEF-P), but not behavior (SDQ).
  • In snorers, OSA directly affected behavior (SDQ) but was not mediated by hearing loss history.

Conclusions:

  • Conductive hearing loss mediates the link between SDB and executive function deficits in early childhood, regardless of SDB severity.
  • Hearing loss does not appear to mediate behavioral difficulties associated with SDB in this age group.
  • Treating hearing loss in preschool children with SDB may offer a pathway to improving executive function.