Neurocognitive assessment and sleep analysis in children with sleep-disordered breathing

Miano, Silvia; Paolino, Maria Chiara; Urbano, Antonella; Parisi, Pasquale; Massolo, Anna Claudia; Castaldo, Rosa; Villa, Maria Pia

doi:10.1016/j.clinph.2010.06.019

Cited by 65 publications

(42 citation statements)

References 42 publications

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“…It is extensively reported that children with SDB display diurnal neurobehavioural problems such as ADHD, learning problems, behavioural disorders and hypersomnolence [32,33]. Although a significant improvement in diurnal neurobehavioral disorders has been widely demonstrated following adenotonsillectomy [32,[34][35][36], the relationship between the severity of OSA syndrome and cognitive deficits is usually weak [37][38][39]. The results of our study support the idea these symptoms are related to SDB but are not specific to OSA.…”

Section: Discussionsupporting

confidence: 78%

Sleep clinical record: an aid to rapid and accurate diagnosis of paediatric sleep disordered breathing

et al. 2012

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Overnight polysomnography (PSG) is an expensive procedure which can only be used in a minority of cases, although it remains the gold standard for the diagnosis of sleep disordered breathing (SDB). The objective of this study was to develop a simple, PSG-validated tool to screen SDB, thus reducing the use of PSG.For every participant we performed PSG and a sleep clinical record was completed. The sleep clinical record consists of three items: physical examination, subjective symptoms and clinical history. The clinical history analyses behavioural and cognitive problems. All three items were used to create a sleep clinical score (SCS).We studied 279 children, mean¡SD age 6.1¡3.1 years, 63.8% male; 27.2% with primary snoring and 72.8% with obstructive sleep apnoea (OSA) syndrome. The SCS was higher in the OSA syndrome group compared to the primary snoring group (8.1¡9.6 versus 0.4¡0.3, p,0.005), correlated with apnoea/hypopnoea index (p50.001) and had a sensitivity of 96.05%. Positive and negative likelihood ratios were 2.91 and 0.06, respectively. SCS may effectively be used to screen patients as candidates for PSG study for suspected OSA syndrome, and to enable those with a mild form of SDB to receive early treatment.

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Section: Discussionsupporting

confidence: 78%

Sleep clinical record: an aid to rapid and accurate diagnosis of paediatric sleep disordered breathing

et al. 2012

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“…In these patients, the arousal index correlated positively with global intelligence, suggesting the hypothesis that arousal is a defensive mechanism that may preserve cognitive functions by counteracting the respiratory events [14]. In the present study, the positive correlation between the arousal index and the severity of OSAS in preschool children could suggest the same defensive mechanism; on the other hand, in our sample, no differences emerged in the three groups in IQ scores.…”

Section: Discussioncontrasting

confidence: 51%

“…Our previous findings suggest that arousal is an important defense mechanism, as it seems to be able to preserve cognitive functions by counteracting cerebral damage hypoxiarelated in school-aged children with SDB [14]. By the analysis of the cyclic alternating pattern (CAP) in NREM sleep, we identified subtle sleep alterations, not detectable with the routine polysomnography (PSG), which might represent a correlate of neurobehavioral morbidity [15].…”

Section: Introductionmentioning

confidence: 97%

Cognitive function in preschool children with sleep-disordered breathing

et al. 2015

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“…c) Studies of low methodological quality (class III or IV) reveal that children with SDB have an increased prevalence of cognitive impairment and academic difficulties, which does not correlate with polysomnography indices [101,102]. In a large population-based cohort study, children with mild SDB showed no significant impairment in intelligence, verbal and nonverbal reasoning ability, attention, executive functioning, memory, processing speed and visual-motor skill compared with children without SDB (class I) [103].…”

Section: Literature Reviewmentioning

confidence: 99%

Obstructive sleep disordered breathing in 2- to 18-year-old children: diagnosis and management

et al. 2015

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This document summarises the conclusions of a European Respiratory Society Task Force on the diagnosis and management of obstructive sleep disordered breathing (SDB) in childhood and refers to children aged 2-18 years. Prospective cohort studies describing the natural history of SDB or randomised, double-blind, placebo-controlled trials regarding its management are scarce. Selected evidence (362 articles) can be consolidated into seven management steps. SDB is suspected when symptoms or abnormalities related to upper airway obstruction are present (step 1). Central nervous or cardiovascular system morbidity, growth failure or enuresis and predictors of SDB persistence in the long-term are recognised (steps 2 and 3), and SDB severity is determined objectively preferably using polysomnography (step 4). Children with an apnoea-hypopnoea index (AHI) >5 episodes·h, those with an AHI of 1-5 episodes·h −1 and the presence of morbidity or factors predicting SDB persistence, and children with complex conditions (e.g. Down syndrome and Prader-Willi syndrome) all appear to benefit from treatment (step 5). Treatment interventions are usually implemented in a stepwise fashion addressing all abnormalities that predispose to SDB (step 6) with re-evaluation after each intervention to detect residual disease and to determine the need for additional treatment (step 7). @ERSpublications Management of obstructive sleep disordered breathing in childhood should follow a stepwise approach

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Neurocognitive assessment and sleep analysis in children with sleep-disordered breathing

Cited by 65 publications

References 42 publications

Sleep clinical record: an aid to rapid and accurate diagnosis of paediatric sleep disordered breathing

Sleep clinical record: an aid to rapid and accurate diagnosis of paediatric sleep disordered breathing

Cognitive function in preschool children with sleep-disordered breathing

Obstructive sleep disordered breathing in 2- to 18-year-old children: diagnosis and management

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