Sleep-disordered breathing and school performance in children.
OBJECTIVE
To assess the impact of sleep-associated gas exchange abnormalities (SAGEA) on school academic performance in children.


METHODS
Prospective study.


METHODS
Urban public elementary schools.


METHODS
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.
Gozal
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Constance S. Kaufman Pediatric Pulmonary Research Laboratory, Tulane University Comprehensive Sleep Disorders Center, New Orleans, Louisiana, USA.
D002648:Child; D002653:Child Behavior Disorders / Q000209:etiology; D004521:Educational Measurement; D005260:Female; D006801:Humans; D007859:Learning Disabilities / Q000209:etiology*; D008297:Male; D011446:Prospective Studies; D011659:Pulmonary Gas Exchange; D012574:Schools; D012891:Sleep Apnea Syndromes / Q000150:complications* / Q000628:therapy; D011795:Surveys and Questionnaires