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Updated: Aug 23, 2026

Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Sleep-disordered breathing and school performance in children
1Constance S. Kaufman Pediatric Pulmonary Research Laboratory, Tulane University Comprehensive Sleep Disorders Center, New Orleans, Louisiana, USA.
Insights
Sleep-associated gas exchange abnormalities (SAGEA) negatively impact school performance in children. Early medical evaluation and treatment for SAGEA may improve learning outcomes for affected students.
Area of Science:
- Pediatric Sleep Medicine
- Educational Psychology
- Respiratory Physiology
Background:
- Sleep-associated gas exchange abnormalities (SAGEA) are increasingly recognized in pediatric populations.
- Poor academic performance in children can stem from various underlying medical conditions.
Purpose of the Study:
- To investigate the correlation between SAGEA and academic performance in first-grade students.
- To determine if medical intervention for SAGEA improves school grades.
Main Methods:
- Prospective study involving 297 first-grade students in the lowest academic percentile.
- Home-based screening for SAGEA using questionnaires, pulse oximetry, and capnography.
- Comparison of academic grades before and after intervention for children with SAGEA.
Main Results:
- SAGEA was identified in 18.1% of underperforming students.
- Children with SAGEA who underwent tonsillectomy and adenoidectomy showed improved grades.
- No significant academic improvement was observed in children with SAGEA who did not receive treatment or in those without SAGEA.
Conclusions:
- SAGEA is a common issue in underperforming students and adversely affects learning.
- Medical evaluation and treatment for SAGEA may benefit children with learning and behavioral challenges.
Objective:
To assess the impact of sleep-associated gas exchange abnormalities (SAGEA) on school academic performance in children.
Design:
Prospective study.
Setting:
Urban public elementary schools.
Participants:
Two hundred ninety-seven first-grade children whose school performance was in the lowest 10th percentile of their class ranking.
Methods:
Children were screened for obstructive sleep apnea syndrome at home using a detailed parental questionnaire and a single night recording of pulse oximetry and transcutaneous partial pressure of carbon dioxide. If SAGEA was diagnosed, parents were encouraged to seek medical intervention for SAGEA. School grades of all participating children for the school year preceding and after the overnight study were obtained.
Results:
SAGEA was identified in 54 children (18.1%). Of these, 24 underwent surgical tonsillectomy and adenoidectomy (TR), whereas in the remaining 30 children, parents elected not to seek any therapeutic intervention (NT). Overall mean grades during the second grade increased from 2.43 +/- 0.17 (SEM) to 2.87 +/- 0.19 in TR, although no significant changes occurred in NT (2.44 +/- 0.13 to 2.46 +/- 0.15). Similarly, no academic improvements occurred in children without SAGEA.
Conclusions:
SAGEA is frequently present in poorly performing first-grade students in whom it adversely affects learning performance. The data suggest that a subset of children with behavioral and learning disabilities could have SAGEA and may benefit from prospective medical evaluation and treatment.
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