Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, OH 05229, USA.
Sleep. 2010 Nov;33(11):1447-56. doi: 10.1093/sleep/33.11.1447.
(1) to determine the associations of sleep disordered breathing (SDB) with behavioral functioning, cognitive test scores, and school grades during middle- to late-childhood, an under-researched developmental period in the SDB literature, and (2) to clarify whether associations between SDB and school grades are mediated by deficits in cognitive or behavioral functioning.
cross-sectional correlative study.
Office/hospital, plus reported functioning at home and at school.
163 overweight subjects aged 10-16.9 years were divided into 4 groups based upon their obstructive apnea+hypopnea index (AHI) during overnight polysomnography and parent report of snoring: Moderate-Severe OSA (AHI > 5, n = 42), Mild OSA (AHI = 1-5, n = 58), Snorers (AHI < 1 + snoring, n = 26), and No SDB (AHI < 1 and nonsnoring, n = 37).
inpatient overnight polysomnography, parent- and self-report of school grades and sleep, parent- and teacher-report of daytime behaviors, and office-based neuropsychological testing.
The 4 groups significantly differed in academic grades and parent- and teacher-reported behaviors, particularly inattention and learning problems. These findings remained significant after adjusting for subject sex, race, socioeconomic status, and school night sleep duration. Associations with SDB were confined to reports of behavioral difficulties in real-world situations, and did not extend to office-based neuropsychological tests. Findings from secondary analyses were consistent with, but could not definitively confirm, a causal model in which SDB affects school grades via its impact on behavioral functioning.
SDB during middle- to late-childhood is related to important aspects of behavioral functioning, especially inattention and learning difficulties, that may result in significant functional impairment at school.
（1）确定睡眠呼吸障碍（SDB）与行为功能、认知测试分数和中学后期儿童学校成绩之间的关联，这是 SDB 文献中研究较少的发育时期；（2）阐明 SDB 与学校成绩之间的关联是否通过认知或行为功能缺陷来介导。
横断面相关性研究。
办公室/医院，加上在家和在学校的报告功能。
163 名超重 10-16.9 岁的受试者根据他们在夜间多导睡眠图期间的阻塞性呼吸暂停+低通气指数（AHI）和父母报告的打鼾情况分为 4 组：中度-重度 OSA（AHI > 5，n = 42）、轻度 OSA（AHI = 1-5，n = 58）、打鼾者（AHI < 1 + 打鼾，n = 26）和无 SDB（AHI < 1 且不打鼾，n = 37）。
住院过夜多导睡眠图、父母和自我报告的学校成绩和睡眠、父母和教师报告的日间行为、以及办公室神经心理学测试。
4 组在学业成绩以及父母和教师报告的行为方面存在显著差异，尤其是注意力不集中和学习问题。这些发现在校正了受试者的性别、种族、社会经济地位和学校夜间睡眠时间后仍然显著。与 SDB 的关联仅限于现实生活中行为困难的报告，而不会扩展到基于办公室的神经心理学测试。二次分析的结果与但不能明确证实一个因果模型一致，即 SDB 通过对行为功能的影响影响学校成绩。
中学后期的 SDB 与行为功能的重要方面有关，特别是注意力不集中和学习困难，这可能导致在学校出现严重的功能障碍。
