Neurobehavioral morbidity of pediatric mild sleep-disordered breathing and obstructive sleep apnea

被引：29

作者：

Yu, Phoebe K. ^{[1
,2
]}

Radcliffe, Jerilynn ^{[3
]}

Taylor, H. Gerry ^{[4
]}

Amin, Raouf S. ^{[5
]}

Baldassari, Cristina M. ^{[6
]}

Boswick, Thomas ^{[6
]}

Chervin, Ronald D. ^{[7
]}

Elden, Lisa M. ^{[8
]}

Furth, Susan L. ^{[9
]}

Garetz, Susan L. ^{[10
]}

George, Alisha ^{[5
]}

Ishman, Stacey L. ^{[11
,12
]}

Kirkham, Erin M. ^{[10
]}

Liu, Christopher ^{[13
]}

Mitchell, Ron B. ^{[13
,14
]}

Naqvi, S. Kamal ^{[14
]}

Rosen, Carol L. ^{[4
]}

Ross, Kristie R. ^{[15
]}

Shah, Jay ^{[16
]}

Tapia, Ignacio E. ^{[9
]}

Young, Lisa R. ^{[9
]}

Zopf, David A. ^{[10
]}

Wang, Rui ^{[1
]}

Redline, Susan ^{[1
,17
]}

机构：

[1] Brigham & Womens Hosp, Div Sleep & Circadian Disorders, 75 Francis St, Boston, MA 02115 USA

[2] Massachusetts Eye & Ear Infirm, Dept Otolaryngol, 243 Charles St, Boston, MA 02114 USA

[3] Childrens Hosp Philadelphia, Div Dev & Behav Pediat, Philadelphia, PA 19104 USA

[4] Case Western Reserve Univ, Sch Med, Dept Pediat, Cleveland, OH 44106 USA

[5] Cincinnati Childrens Hosp Med Ctr, Dept Pediat, Cincinnati, OH 45229 USA

[6] Eastern Virginia Med Sch, Dept Otolaryngol Head & Neck Surg, Childrens Hosp Kings Daughters Dept Pediat Sleep, Norfolk, VA 23501 USA

[7] Univ Michigan, Dept Neurol, Ann Arbor, MI USA

[8] Childrens Hosp Philadelphia, Div Otolaryngol, Philadelphia, PA 19104 USA

[9] Childrens Hosp Philadelphia, Dept Pediat, Philadelphia, PA 19104 USA

[10] Univ Michigan, Dept Otolaryngol Head & Neck Surg, Ann Arbor, MI 48109 USA

[11] Univ Cincinnati, Coll Med, Dept Otolaryngol Head & Neck Surg, Cincinnati, OH USA

[12] Cincinnati Childrens Hosp Med Ctr, Div Otolaryngol Head & Neck Surg, Cincinnati, OH USA

[13] Univ Texas Southwestern, Dept Otolaryngol, Dallas, TX USA

[14] Univ Texas Southwestern, Dept Pediat, Dallas, TX USA

[15] Univ Hosp Rainbow Babies & Childrens Hosp, Dept Pediat, Cleveland, OH USA

[16] Univ Hosp Rainbow Babies & Childrens Hosp, Dept Otolaryngol, Cleveland, OH USA

[17] Harvard TH Chan Sch Publ Hlth, Dept Epidemiol, Boston, MA USA

来源：

SLEEP | 2022年 / 45卷 / 05期

关键词：

pediatric; sleep-disordered breathing; obstructive sleep apnea; behavior; neurocognition; DEFICIT HYPERACTIVITY DISORDER; BEHAVIOR RATING INVENTORY; EXECUTIVE FUNCTION; PRESCHOOL-CHILDREN; COGNITIVE FUNCTION; ADENOTONSILLECTOMY; ADHD; ASSOCIATION; HYPOXIA; TRIAL;

D O I：

10.1093/sleep/zsac035

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Study Objectives Obstructive sleep apnea is associated with neurobehavioral dysfunction, but the relationship between disease severity as measured by the apnea-hypopnea index and neurobehavioral morbidity is unclear. The objective of our study is to compare the neurobehavioral morbidity of mild sleep-disordered breathing versus obstructive sleep apnea. Methods Children 3-12 years old recruited for mild sleep-disordered breathing (snoring with obstructive apnea-hypopnea index < 3) into the Pediatric Adenotonsillectomy Trial for Snoring were compared to children 5-9 years old recruited for obstructive sleep apnea (obstructive apnea-hypopnea 2-30) into the Childhood Adenotonsillectomy Trial. Baseline demographic, polysomnographic, and neurobehavioral outcomes were compared using univariable and multivariable analysis. Results The sample included 453 participants with obstructive sleep apnea (median obstructive apnea-hypopnea index 5.7) and 459 participants with mild sleep-disordered breathing (median obstructive apnea-hypopnea index 0.5). By polysomnography, participants with obstructive sleep apnea had poorer sleep efficiency and more arousals. Children with mild sleep-disordered breathing had more abnormal executive function scores (adjusted odds ratio 1.96, 95% CI 1.30-2.94) compared to children with obstructive sleep apnea. There were also elevated Conners scores for inattention (adjusted odds ratio 3.16, CI 1.98-5.02) and hyperactivity (adjusted odds ratio 2.82, CI 1.83-4.34) in children recruited for mild sleep-disordered breathing. Conclusions Abnormal executive function, inattention, and hyperactivity were more common in symptomatic children recruited into a trial for mild sleep-disordered breathing compared to children recruited into a trial for obstructive sleep apnea. Young, snoring children with only minimally elevated apnea-hypopnea levels may still be at risk for deficits in executive function and attention.

引用

页数：8

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