Long-term cognitive and behavioral outcomes following resolution of sleep disordered breathing in preschool children

Sarah Nichole Biggs, Lisa Mary Walter, Angela Ranee Jackman, Lauren Nisbet, Aidan Weichard, Samantha Hollis, Margot J Davey, Vicki Anne Anderson, Gillian Michelle Nixon, Rosemary Sylvia Claire Horne

Research output: Contribution to journalArticleResearchpeer-review

Abstract

This study aimed to determine the long term effects of resolution of SDB in preschool children, either following treatment or spontaneous recovery, on cognition and behavior. Children diagnosed with SDB at 3-5y (N = 35) and non-snoring controls (N = 25), underwent repeat polysomnography (PSG) and cognitive and behavioral assessment 3 years following a baseline study. At follow-up, children with SDB were grouped into Resolved and Unresolved. Resolution was defined as: obstructive apnea hypopnea index (OAHI) <1 event/h; no snoring detected on PSG; and no parental report of habitual snoring. 57% (20/35) of children with SDB received treatment, with SDB resolving in 60% (12/20). 43% (15/35) were untreated, of whom 40% (6/15) had spontaneous resolution of SDB. Cognitive reduced between baseline and follow-up, however this was not related to persistent disease, with no difference in cognitive outcomes between Resolved, Unresolved or Control groups. Behavioral functioning remained significantly worse in children originally diagnosed with SDB compared to control children, regardless of resolution. Change in OAHI did not predict cognitive or behavioral outcomes, however a reduction in nocturnal arousals, irrespective of full resolution, was associated with improvement in attention and aggressive behavior. These results suggest that resolution of SDB in preschool children has little effect on cognitive or behavioral outcomes over the long term. The association between sleep fragmentation and behavior appears independent of SDB, however may be moderated by concomitant SDB. This challenges the assumption that treatment of SDB will ameliorate associated cognitive and behavioural deficits and supports the possibility of a SDB phenotype.

Original languageEnglish
Article numbere0139142
Number of pages19
JournalPLoS ONE
Volume10
Issue number9
DOIs
Publication statusPublished - 29 Sep 2015

Cite this

@article{235c2d15cfa64d33a0083d5c72d44ee0,
title = "Long-term cognitive and behavioral outcomes following resolution of sleep disordered breathing in preschool children",
abstract = "This study aimed to determine the long term effects of resolution of SDB in preschool children, either following treatment or spontaneous recovery, on cognition and behavior. Children diagnosed with SDB at 3-5y (N = 35) and non-snoring controls (N = 25), underwent repeat polysomnography (PSG) and cognitive and behavioral assessment 3 years following a baseline study. At follow-up, children with SDB were grouped into Resolved and Unresolved. Resolution was defined as: obstructive apnea hypopnea index (OAHI) <1 event/h; no snoring detected on PSG; and no parental report of habitual snoring. 57{\%} (20/35) of children with SDB received treatment, with SDB resolving in 60{\%} (12/20). 43{\%} (15/35) were untreated, of whom 40{\%} (6/15) had spontaneous resolution of SDB. Cognitive reduced between baseline and follow-up, however this was not related to persistent disease, with no difference in cognitive outcomes between Resolved, Unresolved or Control groups. Behavioral functioning remained significantly worse in children originally diagnosed with SDB compared to control children, regardless of resolution. Change in OAHI did not predict cognitive or behavioral outcomes, however a reduction in nocturnal arousals, irrespective of full resolution, was associated with improvement in attention and aggressive behavior. These results suggest that resolution of SDB in preschool children has little effect on cognitive or behavioral outcomes over the long term. The association between sleep fragmentation and behavior appears independent of SDB, however may be moderated by concomitant SDB. This challenges the assumption that treatment of SDB will ameliorate associated cognitive and behavioural deficits and supports the possibility of a SDB phenotype.",
author = "Biggs, {Sarah Nichole} and Walter, {Lisa Mary} and Jackman, {Angela Ranee} and Lauren Nisbet and Aidan Weichard and Samantha Hollis and Davey, {Margot J} and Anderson, {Vicki Anne} and Nixon, {Gillian Michelle} and Horne, {Rosemary Sylvia Claire}",
year = "2015",
month = "9",
day = "29",
doi = "10.1371/journal.pone.0139142",
language = "English",
volume = "10",
journal = "PLoS ONE",
issn = "1932-6203",
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}

Long-term cognitive and behavioral outcomes following resolution of sleep disordered breathing in preschool children. / Biggs, Sarah Nichole; Walter, Lisa Mary; Jackman, Angela Ranee; Nisbet, Lauren; Weichard, Aidan; Hollis, Samantha; Davey, Margot J; Anderson, Vicki Anne; Nixon, Gillian Michelle; Horne, Rosemary Sylvia Claire.

In: PLoS ONE, Vol. 10, No. 9, e0139142, 29.09.2015.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Long-term cognitive and behavioral outcomes following resolution of sleep disordered breathing in preschool children

AU - Biggs, Sarah Nichole

AU - Walter, Lisa Mary

AU - Jackman, Angela Ranee

AU - Nisbet, Lauren

AU - Weichard, Aidan

AU - Hollis, Samantha

AU - Davey, Margot J

AU - Anderson, Vicki Anne

AU - Nixon, Gillian Michelle

AU - Horne, Rosemary Sylvia Claire

PY - 2015/9/29

Y1 - 2015/9/29

N2 - This study aimed to determine the long term effects of resolution of SDB in preschool children, either following treatment or spontaneous recovery, on cognition and behavior. Children diagnosed with SDB at 3-5y (N = 35) and non-snoring controls (N = 25), underwent repeat polysomnography (PSG) and cognitive and behavioral assessment 3 years following a baseline study. At follow-up, children with SDB were grouped into Resolved and Unresolved. Resolution was defined as: obstructive apnea hypopnea index (OAHI) <1 event/h; no snoring detected on PSG; and no parental report of habitual snoring. 57% (20/35) of children with SDB received treatment, with SDB resolving in 60% (12/20). 43% (15/35) were untreated, of whom 40% (6/15) had spontaneous resolution of SDB. Cognitive reduced between baseline and follow-up, however this was not related to persistent disease, with no difference in cognitive outcomes between Resolved, Unresolved or Control groups. Behavioral functioning remained significantly worse in children originally diagnosed with SDB compared to control children, regardless of resolution. Change in OAHI did not predict cognitive or behavioral outcomes, however a reduction in nocturnal arousals, irrespective of full resolution, was associated with improvement in attention and aggressive behavior. These results suggest that resolution of SDB in preschool children has little effect on cognitive or behavioral outcomes over the long term. The association between sleep fragmentation and behavior appears independent of SDB, however may be moderated by concomitant SDB. This challenges the assumption that treatment of SDB will ameliorate associated cognitive and behavioural deficits and supports the possibility of a SDB phenotype.

AB - This study aimed to determine the long term effects of resolution of SDB in preschool children, either following treatment or spontaneous recovery, on cognition and behavior. Children diagnosed with SDB at 3-5y (N = 35) and non-snoring controls (N = 25), underwent repeat polysomnography (PSG) and cognitive and behavioral assessment 3 years following a baseline study. At follow-up, children with SDB were grouped into Resolved and Unresolved. Resolution was defined as: obstructive apnea hypopnea index (OAHI) <1 event/h; no snoring detected on PSG; and no parental report of habitual snoring. 57% (20/35) of children with SDB received treatment, with SDB resolving in 60% (12/20). 43% (15/35) were untreated, of whom 40% (6/15) had spontaneous resolution of SDB. Cognitive reduced between baseline and follow-up, however this was not related to persistent disease, with no difference in cognitive outcomes between Resolved, Unresolved or Control groups. Behavioral functioning remained significantly worse in children originally diagnosed with SDB compared to control children, regardless of resolution. Change in OAHI did not predict cognitive or behavioral outcomes, however a reduction in nocturnal arousals, irrespective of full resolution, was associated with improvement in attention and aggressive behavior. These results suggest that resolution of SDB in preschool children has little effect on cognitive or behavioral outcomes over the long term. The association between sleep fragmentation and behavior appears independent of SDB, however may be moderated by concomitant SDB. This challenges the assumption that treatment of SDB will ameliorate associated cognitive and behavioural deficits and supports the possibility of a SDB phenotype.

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