Long-term changes in neurocognition and behavior following treatment of sleep disordered breathing in school-aged children.
OBJECTIVE
Sleep disordered breathing (SDB) in children is associated with detrimental neurocognitive and behavioral consequences. The long term impact of treatment on these outcomes is unknown. This study examined the long-term effect of treatment of SDB on neurocognition, academic ability, and behavior in a cohort of school-aged children.


METHODS
Four-year longitudinal study. Children originally diagnosed with SDB and healthy non-snoring controls underwent repeat polysomnography and age-standardized neurocognitive and behavioral assessment 4y following initial testing.


METHODS
Melbourne Children's Sleep Centre, Melbourne, Australia.


METHODS
Children 12-16 years of age, originally assessed at 7-12 years, were categorized into Treated (N = 12), Untreated (N = 26), and Control (N = 18) groups.


METHODS
Adenotonsillectomy, Tonsillectomy, Nasal Steroids. Decision to treat was independent of this study.


RESULTS
Changes in sleep and respiratory parameters over time were assessed. A decrease in obstructive apnea hypopnea index (OAHI) from Time 1 to Time 2 was seen in 63% and 100% of the Untreated and Treated groups, respectively. The predictive relationship between change in OAHI and standardized neurocognitive, academic, and behavioral scores over time was examined. Improvements in OAHI were predictive of improvements in Performance IQ, but not Verbal IQ or academic measures. Initial group differences in behavioral assessment on the Child Behavior Checklist did not change over time. Children with SDB at baseline continued to exhibit significantly poorer behavior than Controls at follow-up, irrespective of treatment.


CONCLUSIONS
After four years, improvements in SDB are concomitant with improvements in some areas of neurocognition, but not academic ability or behavior in school-aged children.
The Ritchie Centre, Monash Institute of Medical Research, Monash University, Melbourne, Australia.
Sarah N
SN
Biggs
The Ritchie Centre, Monash Institute of Medical Research, Monash University, Melbourne, Australia.
Anna
A
Vlahandonis
Critical Care and Neuroscience Research, Murdoch Childrens Research Institute, Melbourne, Australia ; Psychological Sciences, University of Melbourne, Melbourne, Australia.
Vicki
V
Anderson
Critical Care and Neuroscience Research, Murdoch Childrens Research Institute, Melbourne, Australia ; Psychological Sciences, University of Melbourne, Melbourne, Australia.
Robert
R
Bourke
The Ritchie Centre, Monash Institute of Medical Research, Monash University, Melbourne, Australia ; Melbourne Children's Sleep Centre, Monash Children's Hospital, Monash Medical Centre, Melbourne, Australia.
Gillian M
GM
Nixon
The Ritchie Centre, Monash Institute of Medical Research, Monash University, Melbourne, Australia ; Melbourne Children's Sleep Centre, Monash Children's Hospital, Monash Medical Centre, Melbourne, Australia.
Margot J
MJ
Davey
The Ritchie Centre, Monash Institute of Medical Research, Monash University, Melbourne, Australia.
Rosemary S C
RS
Horne
D000233:Adenoidectomy; D000281:Administration, Intranasal; D001077:Aptitude Tests; D001143:Arousal / Q000187:drug effects; D002648:Child; D002652:Child Behavior / Q000187:drug effects*; D003071:Cognition / Q000187:drug effects* / Q000502:physiology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009483:Neuropsychological Tests; D017286:Polysomnography; D012119:Respiration / Q000187:drug effects; D012890:Sleep / Q000187:drug effects; D012891:Sleep Apnea Syndromes / Q000150:complications / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy*; D012913:Snoring / Q000503:physiopathology; D013256:Steroids / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use*; D013997:Time Factors; D014068:Tonsillectomy; D014739:Victoria
D013256:Steroids
Children; behavior; cognitive function; sleep disordered breathing; treatment