Neuropsychological and Psychosocial Function in Children with a History of Snoring or Behavioral Sleep Problems

doi:10.1016/j.jpeds.2005.01.043

The Journal of Pediatrics

Volume 146, Issue 6, June 2005, Pages 780-786

https://doi.org/10.1016/j.jpeds.2005.01.043 Get rights and content

Objectives

To compare neuropsychological and psychosocial function in children with a history of snoring, children with a history of behavioral sleep problems (BSP), children with both a history of snoring and BSP, and a group of control subjects.

Study design

Families awaiting consultation for “sick” visits in 5 general practice clinics completed the Sleep Disturbance Scale for Children. A subset of children were categorized into groups: Snorers (n = 11), BSP (n = 13), Snorers+BSP (n = 9), and controls (n = 31). Children underwent psychological (Wechsler Abbreviated Scale of Intelligence, Children's Memory Scale; Test of Everyday Attention and Auditory Continuous Performance Test) and psychosocial assessment (Child Behavior Checklist).

Results

With analysis of variance, it was revealed that, compared with children in the BSP and control groups, those in the Snorers+BSP and Snorers groups showed reduced intelligence and attention scores. By contrast, compared with children in the Snorers and control groups, children in the Snorers+BSP and BSP groups reported reduced social competency, increased problematic behavior, and reduced memory scores. Children in the combination of Snorers+BSP group showed more deficits than children in all other groups.

Conclusion

In children, snoring and BSP, separately and together, are associated with impaired neuropsychological and psychosocial functioning. Furthermore, snoring and BSP are related to performance in disparate ways. Snoring was associated with intelligence and attention deficits, whereas BSP was associated with memory and behavioral deficits.

Section snippets

Subjects

As part of a larger 8 month study, 19 parents of children aged 0 to 16 years who were awaiting consultation for “sick” visits were asked by medical staff at 5 demographically similar general practices in South Australia to complete the Sleep Disorders Scale for Children (SDSC).²³ As estimated with clinic records of average weekly attendance, the percentage of all visiting parent/child pairs who actually completed the survey at the 5 general practices ranged from 19% to 34% (mean, 26.4%). This

Subject Demographics

Of the total sample (n = 64), 59% were girls. Chi-square analyses revealed no significant group differences in paternal or maternal education or occupation, school type (state or private), sex distribution, or time of testing among groups (all P >.05). Analysis of variance revealed no significant between group differences for age (F [3,60] = 2.6, not significant).

Between-group Differences

The mean (±SD) SDSC sleep parameter, neuropsychological, and psychosocial scores are reported in Table II. In summary, questionnaire

Discussion

This study found that snoring was significantly associated with reduced IQ and attentional capacity, but not with reduced memory, and only moderately with problematic behavior. In contrast to snoring, BSP were associated with increased problematic behavior and impaired nonverbal memory, but less with reduced intelligence and attention. When snoring and BSP occur in combination, they have a significantly greater impact on daytime function than when they occur separately.

Previous studies support

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Original ArticleNeuropsychological and Psychosocial Function in Children with a History of Snoring or Behavioral Sleep Problems

Objectives

Study design

Results

Conclusion

Section snippets

Subjects

Subject Demographics

Between-group Differences

Discussion

Sleep Med Rev

Semin Ped Neurol

J Pediatr

Neurosci Biobehav Rev

The effect of sleep fragmentation on daytime function

Sleep

Sleep disordered breathing in school aged children: impact on school performance

Pediatrics

Cognitive function following acute sleep restriction in children ages 10-14

Sleep

Sleep disordered breathing and neuropsychological deficits

Am J Resp Crit Care Med

Cognitive executive dysfunction in patients with obstructive sleep apnea syndrome after CPAP treatment

Sleep

Obstructive sleep apnea and the prefrontal cortex: towards a comprehensive model linking nocturnal upper airway obstruction to daytime cognitive and behavioural deficits

J Sleep Res

Reduced neurocognitive function in children who snore

Ped Pulmonol

Neuropsychological sequelae of obstructive sleep apnea in children

Sleep Research

Children and nocturnal snoring: evaluation of the effects of sleep related respiratory resistive load and daytime functioning

J Pediatr

Sleep disordered breathing: effects of adenotonsillectomy on behaviour and psychological functioning

Eur J Pediatr

Snoring, intermittent hypoxia and academic performance in primary school children

Am J Respir Crit Care Med

Sleep and behaviour in children with obstructive sleep apnea and behavioural sleep disorders

Pediatrics

Snoring in children: association with respiratory symptoms and passive smoking

BMJ

Snoring in French preschool children

Pediatr Pulmonol

Snoring and obstructive sleep apnea in Thai school-age children: prevalence and predisposing factors

Pediatr Pulmonol

Original Article
Neuropsychological and Psychosocial Function in Children with a History of Snoring or Behavioral Sleep Problems