title: Sleep Disturbances and Neurobehavioral Performance in Juvenile Idiopathic Arthritis.
abstract: To examine the extent of polysomnographic (PSG) sleep disturbances [obstructive apnea hypopnea index (OAHI), number of wake bouts, arousals, periodic limb movements] and the effect of OAHI on neurobehavioral performance in juvenile idiopathic arthritis (JIA) with obstructive sleep apnea (OSA), JIA without OSA, and controls without OSA, adjusting for intelligence quotient (IQ), pain, medications, daytime sleepiness, and wake bouts.
  
  
  
  Children 6-11 years, 68 with JIA and 67 controls, underwent 1 night of PSG and completed self-reported daytime sleepiness surveys, multiple sleep latency tests for physiological sleepiness, and neurobehavioral performance tests the next day.
  
  
  
  Compared with JIA and controls without OSA, mean OAHI and arousals were significantly higher in JIA with OSA (p < 0.001, respectively). In comparison with JIA and controls without OSA, mean simple reaction time and sustained attention were significantly slower in JIA with OSA, adjusting for IQ, pain, any medication, daytime sleepiness, and wake bouts.
  
  
  
  Elevated OAHI is suggestive of obstructive sleep apnea and a comorbidity in JIA that may predispose children with JIA to daytime sleepiness and impaired neurobehavioral performance.
authors.affiliation: From the School of Nursing, University of Washington; Seattle Children's Hospital, Department of Pediatrics, Division of Pulmonary and Sleep Medicine, University of Washington School of Medicine; Seattle Children's Hospital, Department of Pediatrics, Division of Rheumatology, University of Washington School of Medicine, Seattle, Washington; Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA. teward@uw.edu.|T.M. Ward, PhD, Associate Professor, School of Nursing, University of Washington; D.W. Beebe, PhD, ABPP, Professor, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, and Department of Pediatrics, University of Cincinnati College of Medicine; M.L. Chen, MD, Associate Professor, Seattle Children's Hospital, Department of Pediatrics, Division of Pulmonary and Sleep Medicine, University of Washington School of Medicine; C.A. Landis, PhD, Professor, School of Nursing, University of Washington; S. Ringold, MS, MD, Associate Professor, Seattle Children's Hospital, Department of Pediatrics, Division of Rheumatology, University of Washington School of Medicine; K. Pike, PhD, Statistician, School of Nursing, University of Washington; C.A. Wallace, MD, Professor, Seattle Children's Hospital, Department of Pediatrics, Division of Rheumatology, University of Washington School of Medicine. teward@uw.edu.
authors.forename: Teresa M
authors.initials: TM
authors.lastname: Ward
authors.affiliation: From the School of Nursing, University of Washington; Seattle Children's Hospital, Department of Pediatrics, Division of Pulmonary and Sleep Medicine, University of Washington School of Medicine; Seattle Children's Hospital, Department of Pediatrics, Division of Rheumatology, University of Washington School of Medicine, Seattle, Washington; Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.|T.M. Ward, PhD, Associate Professor, School of Nursing, University of Washington; D.W. Beebe, PhD, ABPP, Professor, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, and Department of Pediatrics, University of Cincinnati College of Medicine; M.L. Chen, MD, Associate Professor, Seattle Children's Hospital, Department of Pediatrics, Division of Pulmonary and Sleep Medicine, University of Washington School of Medicine; C.A. Landis, PhD, Professor, School of Nursing, University of Washington; S. Ringold, MS, MD, Associate Professor, Seattle Children's Hospital, Department of Pediatrics, Division of Rheumatology, University of Washington School of Medicine; K. Pike, PhD, Statistician, School of Nursing, University of Washington; C.A. Wallace, MD, Professor, Seattle Children's Hospital, Department of Pediatrics, Division of Rheumatology, University of Washington School of Medicine.
authors.forename: Dean W
authors.initials: DW
authors.lastname: Beebe
authors.affiliation: From the School of Nursing, University of Washington; Seattle Children's Hospital, Department of Pediatrics, Division of Pulmonary and Sleep Medicine, University of Washington School of Medicine; Seattle Children's Hospital, Department of Pediatrics, Division of Rheumatology, University of Washington School of Medicine, Seattle, Washington; Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.|T.M. Ward, PhD, Associate Professor, School of Nursing, University of Washington; D.W. Beebe, PhD, ABPP, Professor, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, and Department of Pediatrics, University of Cincinnati College of Medicine; M.L. Chen, MD, Associate Professor, Seattle Children's Hospital, Department of Pediatrics, Division of Pulmonary and Sleep Medicine, University of Washington School of Medicine; C.A. Landis, PhD, Professor, School of Nursing, University of Washington; S. Ringold, MS, MD, Associate Professor, Seattle Children's Hospital, Department of Pediatrics, Division of Rheumatology, University of Washington School of Medicine; K. Pike, PhD, Statistician, School of Nursing, University of Washington; C.A. Wallace, MD, Professor, Seattle Children's Hospital, Department of Pediatrics, Division of Rheumatology, University of Washington School of Medicine.
authors.forename: Maida Lynn
authors.initials: ML
authors.lastname: Chen
authors.affiliation: From the School of Nursing, University of Washington; Seattle Children's Hospital, Department of Pediatrics, Division of Pulmonary and Sleep Medicine, University of Washington School of Medicine; Seattle Children's Hospital, Department of Pediatrics, Division of Rheumatology, University of Washington School of Medicine, Seattle, Washington; Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.|T.M. Ward, PhD, Associate Professor, School of Nursing, University of Washington; D.W. Beebe, PhD, ABPP, Professor, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, and Department of Pediatrics, University of Cincinnati College of Medicine; M.L. Chen, MD, Associate Professor, Seattle Children's Hospital, Department of Pediatrics, Division of Pulmonary and Sleep Medicine, University of Washington School of Medicine; C.A. Landis, PhD, Professor, School of Nursing, University of Washington; S. Ringold, MS, MD, Associate Professor, Seattle Children's Hospital, Department of Pediatrics, Division of Rheumatology, University of Washington School of Medicine; K. Pike, PhD, Statistician, School of Nursing, University of Washington; C.A. Wallace, MD, Professor, Seattle Children's Hospital, Department of Pediatrics, Division of Rheumatology, University of Washington School of Medicine.
authors.forename: Carol A
authors.initials: CA
authors.lastname: Landis
authors.affiliation: From the School of Nursing, University of Washington; Seattle Children's Hospital, Department of Pediatrics, Division of Pulmonary and Sleep Medicine, University of Washington School of Medicine; Seattle Children's Hospital, Department of Pediatrics, Division of Rheumatology, University of Washington School of Medicine, Seattle, Washington; Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.|T.M. Ward, PhD, Associate Professor, School of Nursing, University of Washington; D.W. Beebe, PhD, ABPP, Professor, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, and Department of Pediatrics, University of Cincinnati College of Medicine; M.L. Chen, MD, Associate Professor, Seattle Children's Hospital, Department of Pediatrics, Division of Pulmonary and Sleep Medicine, University of Washington School of Medicine; C.A. Landis, PhD, Professor, School of Nursing, University of Washington; S. Ringold, MS, MD, Associate Professor, Seattle Children's Hospital, Department of Pediatrics, Division of Rheumatology, University of Washington School of Medicine; K. Pike, PhD, Statistician, School of Nursing, University of Washington; C.A. Wallace, MD, Professor, Seattle Children's Hospital, Department of Pediatrics, Division of Rheumatology, University of Washington School of Medicine.
authors.forename: Sarah
authors.initials: S
authors.lastname: Ringold
authors.affiliation: From the School of Nursing, University of Washington; Seattle Children's Hospital, Department of Pediatrics, Division of Pulmonary and Sleep Medicine, University of Washington School of Medicine; Seattle Children's Hospital, Department of Pediatrics, Division of Rheumatology, University of Washington School of Medicine, Seattle, Washington; Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.|T.M. Ward, PhD, Associate Professor, School of Nursing, University of Washington; D.W. Beebe, PhD, ABPP, Professor, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, and Department of Pediatrics, University of Cincinnati College of Medicine; M.L. Chen, MD, Associate Professor, Seattle Children's Hospital, Department of Pediatrics, Division of Pulmonary and Sleep Medicine, University of Washington School of Medicine; C.A. Landis, PhD, Professor, School of Nursing, University of Washington; S. Ringold, MS, MD, Associate Professor, Seattle Children's Hospital, Department of Pediatrics, Division of Rheumatology, University of Washington School of Medicine; K. Pike, PhD, Statistician, School of Nursing, University of Washington; C.A. Wallace, MD, Professor, Seattle Children's Hospital, Department of Pediatrics, Division of Rheumatology, University of Washington School of Medicine.
authors.forename: Ken
authors.initials: K
authors.lastname: Pike
authors.affiliation: From the School of Nursing, University of Washington; Seattle Children's Hospital, Department of Pediatrics, Division of Pulmonary and Sleep Medicine, University of Washington School of Medicine; Seattle Children's Hospital, Department of Pediatrics, Division of Rheumatology, University of Washington School of Medicine, Seattle, Washington; Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.|T.M. Ward, PhD, Associate Professor, School of Nursing, University of Washington; D.W. Beebe, PhD, ABPP, Professor, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, and Department of Pediatrics, University of Cincinnati College of Medicine; M.L. Chen, MD, Associate Professor, Seattle Children's Hospital, Department of Pediatrics, Division of Pulmonary and Sleep Medicine, University of Washington School of Medicine; C.A. Landis, PhD, Professor, School of Nursing, University of Washington; S. Ringold, MS, MD, Associate Professor, Seattle Children's Hospital, Department of Pediatrics, Division of Rheumatology, University of Washington School of Medicine; K. Pike, PhD, Statistician, School of Nursing, University of Washington; C.A. Wallace, MD, Professor, Seattle Children's Hospital, Department of Pediatrics, Division of Rheumatology, University of Washington School of Medicine.
authors.forename: Carol A
authors.initials: CA
authors.lastname: Wallace
mesh_terms: D001171:Arthritis, Juvenile / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D001288:Attention / Q000502:physiology; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D017286:Polysomnography; D011930:Reaction Time / Q000502:physiology; D012890:Sleep / Q000502:physiology*; D012893:Sleep Wake Disorders / Q000150:complications* / Q000503:physiopathology / Q000523:psychology
keywords: CANTAB; DAYTIME SLEEPINESS; JUVENILE IDIOPATHIC ARTHRITIS; NEUROBEHAVIORAL PERFORMANCE; OBSTRUCTIVE SLEEP APNEA; POLYSOMNOGRAPHY