Variation of cognition and achievement with sleep-disordered breathing in full-term and preterm children.
OBJECTIVE
Pediatric sleep-disordered breathing (SDB) has a disproportionately high prevalence in children who were preterm infants (preterm children) and is associated with behavioral comorbidity. Exposure to intermittent hypoxemia and sleep disruption may contribute to cognitive impairment. We quantified the association of SDB with cognition and achievement and determined whether preterm children are at a differentially increased risk for SDB-related impairments.


METHODS
Cross-sectional analyses.


METHODS
Urban community.


METHODS
Eight hundred thirty-five children, aged 8 to 11 years.Intervention(s) None.


METHODS
Scores on the Peabody Picture Vocabulary Test-Revised, Kaufman Assessment Battery for Children, and Continuous Performance Test.


RESULTS
One hundred sixty-four children had SDB. In unadjusted analyses, children with SDB had poorer scores on almost all tests of cognition and achievement. Group differences were attenuated after adjusting for socioeconomic status; in these analyses, children with SDB scored lower on the Peabody Picture Vocabulary Test-Revised (mean +/- SE score, 100.5 +/- 1.4 vs 103.6 +/- 0.7; P = .04), and the Kaufman Assessment Battery for Children riddles and triangles subscales. Associations were stronger in preterm than in full-term children. Of the sleep measures, snoring history was most strongly correlated with indices of cognition and achievement.


CONCLUSIONS
Although moderate group differences were observed for almost all cognitive measures, an attenuation of effects was observed once socioeconomic status was considered. The deficits in selective measures of academic abilities, language comprehension, and planning and organizational skills suggest a negative impact of SDB on achievement and cognition. Stronger associations in preterm children suggest the importance of screening for snoring, a good predictor of cognitive function in this population.
Emancipator
Judy L
JL
Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve School of Medicine, Cleveland, OH 44106-6003, USA.
Storfer-Isser
Amy
A
Taylor
H Gerry
HG
Rosen
Carol L
CL
Kirchner
H L
HL
Johnson
Nathan L
NL
Zambito
Anne Marie
AM
Redline
Susan
S
D002648:Child; D003072:Cognition Disorders / Q000209:etiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000150:complications*; D014477:Underachievement