title: Neuropsychological and behavioral functioning in children with and without obstructive sleep apnea referred for tonsillectomy.
abstract: Adenotonsillectomy (AT) is among the most common pediatric surgical procedures and is performed as often for obstructive sleep apnea (OSA) as for recurrent tonsillitis. This study compared behavioral, cognitive, and sleep measures in 27 healthy control children recruited from a university hospital-based pediatric general surgery clinic with 40 children who had OSA (AT/OSA+) and 27 children who did not have OSA (AT/OSA-) scheduled for AT. Parental ratings of behavior, sleep problems, and snoring, along with specific cognitive measures (i.e., short-term attention, visuospatial problem solving, memory, arithmetic) reflected greater difficulties for AT children compared with controls. Differences between the AT/OSA- and control groups were larger and more consistent across test measures than were those between the AT/OSA+ and control groups. The fact that worse outcomes were not clearly demonstrated for the AT/OSA+ group compared with the other groups was not expected based on existing literature. This counterintuitive finding may reflect a combination of factors, including age, daytime sleepiness, features of sleep-disordered breathing too subtle to show on standard polysomnography, and academic or environmental factors not collected in this study. These results underscore the importance of applying more sophisticated methodologies to better understand the salient pathophysiology of childhood sleep-disordered breathing.
authors.affiliation: Neuropsychology Section, Department of Psychiatry, University of Michigan, Ann Arbor, Michigan 48105-0716, USA. giordani@umich.edu
authors.forename: Bruno
authors.initials: B
authors.lastname: Giordani
authors.forename: Elise K
authors.initials: EK
authors.lastname: Hodges
authors.forename: Kenneth E
authors.initials: KE
authors.lastname: Guire
authors.forename: Deborah L
authors.initials: DL
authors.lastname: Ruzicka
authors.forename: James E
authors.initials: JE
authors.lastname: Dillon
authors.forename: Robert A
authors.initials: RA
authors.lastname: Weatherly
authors.forename: Susan L
authors.initials: SL
authors.lastname: Garetz
authors.forename: Ronald D
authors.initials: RD
authors.lastname: Chervin
mesh_terms: D000124:Achievement; D000233:Adenoidectomy; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis* / Q000523:psychology; D002675:Child, Preschool; D003072:Cognition Disorders / Q000175:diagnosis* / Q000523:psychology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D010552:Personality Assessment; D017286:Polysomnography; D011183:Postoperative Complications / Q000175:diagnosis* / Q000523:psychology; D012017:Referral and Consultation; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000601:surgery*; D014068:Tonsillectomy