title: Sleep disordered breathing as measured by SRBD-PSQ and neurocognition in children with hypertension.
abstract: BACKGROUND
  Cognitive test performance is decreased in hypertensive adults and children, a finding postulated to represent early target-organ damage to the brain. Hypertensive children are often obese, a comorbidity associated with sleep disordered breathing (SDB), itself associated with cognitive problems; potentially confounding the relation between hypertension (HTN) and neurocognition. Our objective was to determine the association between SDB as measured by a scale and questionnaire score and neurocognition among participants enrolled in an ongoing multicenter study of cognition in children with HTN.
  
  
  METHODS
  Subjects completed laboratory-based neurocognitive tests. Parents and subjects completed rating scales of executive function, mood, and behavior problems. Parents completed the Sleep-Related Breathing Disorder scale of the Pediatric Sleep Questionnaire (SRBD-PSQ).
  
  
  RESULTS
  To date, 38 HTN subjects and 34 control subjects have completed neurocognitive testing and the SRBD-PSQ. Median SRBD-PSQ scores were similar between groups but the HTN group had a higher percentage of subjects with SRBD-PSQ scores in the range suggestive of obstructive sleep apnea (26% vs. 6%, P = 0.03). Overall, higher SRBD-PSQ scores were not significantly associated with worse performance on laboratory-based measures of executive function and other cognitive domains but were significantly associated with worse scores on rating scales of executive function as well as mood and behavior problems.
  
  
  CONCLUSIONS
  A larger proportion of children with HTN had scores suggestive of SDB. The results underscore the importance of using a multi-method approach in the assessment of cognition and adjusting for potential confounding effects of SDB in studies of cognition in hypertensive children.
authors.affiliation: Department of Pediatrics, University of Rochester, Rochester, New York, USA; Marc_lande@urmc.rochester.edu.
authors.forename: Marc B
authors.initials: MB
authors.lastname: Lande
authors.affiliation: Departments of Psychiatry and Allied Health Sciences, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA;
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Hooper
authors.affiliation: Department of Pediatrics, Emory University, Atlanta, Georgia, USA;
authors.forename: Donald L
authors.initials: DL
authors.lastname: Batisky
authors.affiliation: Department of Pediatrics, Maimonides Medical Center, Brooklyn, New York, USA;
authors.forename: Juan C
authors.initials: JC
authors.lastname: Kupferman
authors.affiliation: Department of Pediatrics, University of Rochester, Rochester, New York, USA;
authors.forename: Peter G
authors.initials: PG
authors.lastname: Szilagyi
authors.affiliation: Department of Pediatrics, University of Texas-Houston, Houston, Texas, USA;
authors.forename: Joshua A
authors.initials: JA
authors.lastname: Samuels
authors.affiliation: Department of Neurology, University of Rochester, Rochester, New York, USA.
authors.forename: Heather R
authors.initials: HR
authors.lastname: Adams
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000339:Affect; D000367:Age Factors; D016022:Case-Control Studies; D002648:Child; D002652:Child Behavior; D003071:Cognition; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D056344:Executive Function; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D008297:Male; D009483:Neuropsychological Tests; D063766:Pediatric Obesity / Q000175:diagnosis / Q000453:epidemiology; D011237:Predictive Value of Tests; D015995:Prevalence; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
keywords: blood pressure; cognition; executive function; hypertension; sleep apnea.