Early polysomnographic characteristics associated with neurocognitive development at 36 months of age

Abstract

Background. Few studies on the relationship between sleep quantity and/or quality and cognition have been conducted among preschoolers from the healthy general population. We aimed at identifying, among 3-year-old children, early polysomnography (PSG) sleep factors associated with intelligence quotient (IQ) estimated using the Weschler Preschool and Primary Scale Intelligence-III test (WPPSI-III) and its indicators: full-scale (FISQ), verbal (VIQ), and performance (PIQ) intelligence quotients. Methods. We included full-term children from the French birth-cohort AuBE with both PSG recording at term (M0) or 6 months (M6) and available WPPSI-III scores at 3 years. Sleep and arousal characteristics of these infants were evaluated during day and night sleep periods. Relationships between IQ scores and sleep parameters were estimated using models with child as repeated effect adjusted for time (night/day), maturation (M0/M6), tobacco exposure (yes/no), anxiety depressive scores during pregnancy, maternal age, duration of breastfeeding and child gender. Results. A total of 118 PSG recordings were included, representing a total 78 unique children (38 with one PSG and 40 with 2 PSG). No correlations were found between night and day sleep durations at M0 or M6. Mean VIQ, PIQ, and FSIQ scores were within normal ranges. In multivariate models, longer sleep duration, higher sleep efficiency during day were negatively associated with all IQ scores. More frequent arousals during night were associated with lower VIQ scores. Conclusion. Early sleep characteristics such as night sleep fragmentation or longer naps could be associated with impaired cognitive function at 3 years of age.

Associations of sleep duration with neurocognitive development in the first 2 years of life

“…They found that children who slept longer during the day had poor cognitive function, and those who slept less at night also had poor performance (Lam, Mahone, Mason, & Scharf, 2011). Franco et al (2019) assessed sleep duration among 40 children aged 0 and/or 6 months, and measured cognitive function among children who were 3 years old, and found that long daytime sleep duration was negatively associated with all intelligence quotient scales. These studies seem to support our findings further that long daytime or short nighttime sleep duration was associated with lower neurocognitive development scores.…”

“…Besides, Bernier et al (2013) also reported that no significant association of total sleep duration at 1 year with cognitive function at 4 years had been found based on a longitudinal study design. However, Franco et al reported that longer daytime sleep durations at 0 and 6 months were negatively associated with all IQ scores at 3 years (Franco et al, 2019). Sivertsen et al’s study followed the children to 5 years, and reported short total sleep duration at 18 months was significantly predicated both concurrent and later emotional problems (Sivertsen et al, 2015).…”

Phenotypical Characterization of Obstructive Sleep Apnea in Premature Infants using Polysomnography

“…Disturbances in sleep architecture, specifically increased arousals, have been associated with impaired cognitive function. 13,17 Infants with lower scores on standardized mental developmental assessments have higher snoring-arousal indices in the absence of apnea and hypopnea, so arousal is evidence of a disease association. 18 These findings underscore the importance of early diagnosis and monitoring aimed at improving sleep quality in premature children.…”

Prematurity as a Risk Factor of Sleep-Disordered Breathing in Children Younger Than Two Years: A Retrospective Case-Control Study

“…In a recent study of 3-year-old children, sleep fragmentation and increased arousals were associated with impaired cognitive function, specifically in the verbal IQ domain. 29 Consequently, the PRETERM group may benefit from interventions aimed at improving sleep quality. Additionally, growth failure is a well-established consequence of SDB in childhood, 30 and the mechanisms underlying delayed somatic growth include increased energy expenditure due to labored breathing, systemic inflammation, and suppression of growth hormone signaling.…”