Gottlieb Daniel J, Chase Cynthia, Vezina Richard M, Heeren Timothy C, Corwin Michael J, Auerbach Sanford H, Weese-Mayer Debra E, Lesko Samuel M
Department of Medicine, Slone Epidemiology Center, Boston University School of Medicine, Boston, Massachusetts 02118-2394, USA.
J Pediatr. 2004 Oct;145(4):458-64. doi: 10.1016/j.jpeds.2004.05.039.
To assess the relation of sleep-disordered breathing (SDB) symptoms in children to neurocognitive function.
A cross-sectional, population-based study of 205 5-year-old children. A parent-completed questionnaire was used to ascertain SDB symptoms, defined as frequent snoring, loud or noisy breathing during sleep, or witnessed sleep apnea. Polysomnography (PSG) data were available in 85% of children. Standardized neurocognitive tests were administered by a trained psychometrist unaware of the children's SDB status. Children with (n=61) and without SDB symptoms were compared using analysis of variance to adjust for demographic and respiratory health variables.
Children with SDB symptoms scored significantly lower than those without SDB symptoms on tests of executive function (95.5 vs 99.9 on NEPSY Attention/Executive Core Domain, P=.02; 10.4 vs 11.2 on Wechsler Preschool and Primary Scale of Intelligence, Revised [WPPSI-R] Animal Pegs test, P=.03), memory (96.8 vs 103.0 on NEPSY Memory Domain, P=.02), and general intellectual ability (105.9 vs 111.7 on WPPSI-R Full Scale IQ, P=.02). There were no significant differences on a computerized continuous performance task. These findings persisted when children with PSG evidence of obstructive sleep apnea (OSA) were excluded from analysis.
Even in the absence of OSA, SDB symptoms are associated with poorer executive function and memory skills and lower general intelligence in 5-year-old children.
评估儿童睡眠呼吸障碍(SDB)症状与神经认知功能之间的关系。
一项基于人群的横断面研究,纳入205名5岁儿童。采用家长填写的问卷来确定SDB症状,定义为频繁打鼾、睡眠期间呼吸声大或嘈杂,或观察到睡眠呼吸暂停。85%的儿童有多导睡眠图(PSG)数据。由一名经过培训且不知道儿童SDB状况的心理测量师进行标准化神经认知测试。使用方差分析对有(n = 61)和无SDB症状的儿童进行比较,以调整人口统计学和呼吸健康变量。
有SDB症状的儿童在执行功能测试(NEPSY注意力/执行核心领域得分95.5 vs 99.9,P = 0.02;韦氏学前及初小儿童智力量表修订版[WPPSI-R]动物钉板测试得分10.4 vs 11.2,P = 0.03)、记忆测试(NEPSY记忆领域得分96.8 vs 103.0,P = 0.02)和一般智力能力测试(WPPSI-R全量表智商得分105.9 vs 111.7,P = 0.02)中的得分显著低于无SDB症状的儿童。在计算机化持续操作任务中没有显著差异。当排除有PSG证据显示阻塞性睡眠呼吸暂停(OSA)的儿童进行分析时,这些发现仍然存在。
即使没有OSA,SDB症状也与5岁儿童较差的执行功能、记忆技能和较低的一般智力相关。