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Neurocognitive outcomes of children with sleep disordered breathing: A systematic review with meta-analysis

Bethanie Menzies1, Arthur Teng2, Mary Burns1

  • 1School of Psychology, University of Sydney, Sydney, Australia.

Sleep Medicine Reviews
|April 19, 2022
PubMed

Insights

Children with sleep disordered breathing (SDB) experience significant neurocognitive impairments across all domains, including intelligence and attention. These deficits persist even in milder forms like primary snoring, highlighting the need for early intervention.

Area of Science:

  • Pediatric Neurology
  • Sleep Medicine
  • Cognitive Neuroscience

Background:

  • Sleep disordered breathing (SDB) is increasingly recognized as a risk factor for neurodevelopmental issues in children.
  • Previous research suggests a link between SDB and cognitive deficits, but a comprehensive analysis across domains and severities is needed.

Purpose of the Study:

  • To systematically review and meta-analyze the impact of SDB on various neurocognitive domains in children.
  • To investigate the influence of moderating factors, such as SDB severity and study methodologies, on neurocognitive outcomes.

Main Methods:

  • A systematic literature search was conducted following PRISMA guidelines, identifying 77 relevant studies.
  • A meta-analysis included 63 studies of moderate to high quality to assess SDB's impact on intelligence, attention, memory, visual-spatial skills, and language.
  • Moderating factors including SDB severity (primary snoring vs. obstructive sleep apnea), BMI, age, and methodology were examined.

Main Results:

  • Children with SDB exhibited significant impairments across all assessed neurocognitive domains, with the most pronounced deficits in intelligence (verbal and overall).
  • Neurocognitive deficits were observed in both primary snoring and obstructive sleep apnea groups, indicating no 'sparing' effect in milder SDB.
  • Factors such as higher BMI, younger age at testing, and reliance on questionnaires over polysomnography were associated with poorer cognitive outcomes.

Conclusions:

  • This meta-analysis provides robust evidence of widespread neurocognitive impairments in children with SDB, irrespective of severity.
  • The findings underscore the critical need for early identification and intervention for SDB in children to mitigate long-term cognitive consequences.
  • Further research is warranted to explore targeted interventions for improving cognitive function in affected children.

Keywords:
ApnoeaChildrenCognitionSleepSnoring

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