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Children with sleep disordered breathing (SDB) show similar neurocognitive and behavioral outcomes whether diagnosed with primary snoring (PS) or obstructive sleep apnea (OSA). Symptoms, not just apnea indices, should guide treatment decisions for SDB in children.

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Area of Science:

  • Pediatric Sleep Medicine
  • Neurocognition
  • Behavioral Science

Background:

  • Sleep disordered breathing (SDB) in children exists on a spectrum from primary snoring (PS) to obstructive sleep apnea (OSA).
  • Diagnosis is typically based on apnea indices from polysomnography (PSG).
  • This research was registered under ACTRN12611000021976.

Purpose of the Study:

  • To evaluate differences in neurocognitive and behavioral parameters in pre-school children with PSG-diagnosed OSA versus PS before treatment.
  • To compare symptomatic children with SDB based on PSG findings.

Main Methods:

  • Ninety-one symptomatic pre-school children with positive Pediatric Sleep Questionnaire (PSQ) results were enrolled in the POSTA study.
  • Neurocognitive and behavioral data were analyzed and compared between PS (Obstructive Apnea-Hypopnea Index < 1/h) and OSA (1-10/h) groups.
  • Children were deemed suitable for adenotonsillectomy by an ENT surgeon.

Main Results:

  • No significant differences were observed in neurocognitive or behavioral parameters between children diagnosed with OSA and those with PS.
  • IQ distribution was slightly skewed towards higher values compared to the reference population.
  • Fifty-two children had OSA and 39 had PS.

Conclusions:

  • Neurocognitive and behavioral parameters are similar in pre-school children with symptoms of OSA, irrespective of PSG diagnosis of PS or OSA.
  • Current treatment approaches often differ despite identical symptoms and outcomes.
  • The study suggests considering symptoms and behavioral disturbances alongside the Obstructive Apnea-Hypopnea Index (OAHI) for treatment decisions.