The influence of body mass on long-term cognitive performance of children treated for sleep-disordered breathing

Background: Long-term follow-up of children treated for sleep-disordered breathing (SDB) is limited, as the examination of factors potentially contributing to recovery is also limited. This study aimed to examine whether the recovery of neurocognitive function is achieved at four years post-adenotonsillectomy for SDB in children and whether body mass status influences the outcome. Methods: This prospective longitudinal study of 3- to 12-year-old children recruited from an otolaryngology clinic compared cognitive performance, sleep, ventilation, and body mass before and at four years post-adenotonsillectomy in children with SDB and compared these parameters to those of untreated healthy controls during the same time points. Results: Children were categorised as normal-weight control (n = 33), normal-weight SDB (n = 18), or overweight/obese SDB (n = 11). Body mass did not significantly differ at four year follow-up compared to the baseline in any subgroup (p > 0.05), and groups were matched on the basis of age and gender. Despite improved sleep and nocturnal ventilation at four years post-adenotonsillectomy, little gain was observed in neurocognitive performance in either nonobese or overweight/obese children with SDB. Overweight/obese children with SDB displayed worse neurocognitive performance than all other children. Conclusion: Adenotonsillectomy improves nocturnal ventilation and sleep quality but not neurocognitive performance in the long term. Excess body mass may place children with SDB at increased risk of neurocognitive performance deficits. (C) 2018 Elsevier B.V. All rights reserved.