Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health (NCCH), Beijing, 100045, China; Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, MOE Key Laboratory of Major Diseases in Children, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health (NCCH), Beijing, 100045, China.
Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, MOE Key Laboratory of Major Diseases in Children, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health (NCCH), Beijing, 100045, China.
Sleep Med. 2018 Oct;50:132-136. doi: 10.1016/j.sleep.2018.04.009. Epub 2018 Jun 9.
Childhood obstructive sleep apnea-hypopnea syndrome (OSAHS), the most common sleep-related breathing disorder, may lead to cognitive impairment. This study aims to investigate the association between mild or moderate childhood OSAHS and cognitive dysfunction.
A total of 59 children (4-12 years of age) diagnosed with mild or moderate OSAHS by polysomnography and 60 age- and sex-matched healthy children were included in the study. The China-Wechsler Younger Children Scale of Intelligence and China-Wechsler Intelligence Scale for Children were used to evaluate the cognition of the participating children aged <6 years and ≥6 years, respectively.
In the <6-years-old subgroup, children with OSAHS had significantly lower scores of full-scale IQ (FIQ), verbal IQ (VIQ), comprehension test, and visual analysis than the healthy children (all p < 0.05). In the ≥6-years-old subgroup, VIQ and classification test scores were significantly lower in children with OSAHS than in the healthy controls (all p < 0.05). FIQ, VIQ, and performance IQ (PIQ) scores did not correlate with AHI, OAHI, and the lowest nocturnal SO. Notably, in the <6-years-old subgroup of OSAHS, the accumulated time of SO<90% (p = 0.046) and the percentage of the accumulated time of SO<90% in the total sleep time (p = 0.034) correlated with PIQ negatively and significantly.
Mild to moderate childhood OSAHS may adversely affect cognitive function, particularly in young children (<6 years of age). This study may increase the awareness of childhood OSAHS-associated cognitive dysfunction and advocate early interventions in childhood OSAHS.
儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)是最常见的睡眠相关呼吸障碍,可能导致认知障碍。本研究旨在探讨轻度或中度儿童 OSAHS 与认知功能障碍的关系。
本研究共纳入 59 例经多导睡眠图诊断为轻度或中度 OSAHS 的儿童(4-12 岁)和 60 例年龄和性别匹配的健康儿童。采用中国韦氏幼儿智力量表和中国韦氏儿童智力量表分别评估<6 岁和≥6 岁儿童的认知功能。
在<6 岁亚组中,OSAHS 患儿的全量表智商(FIQ)、言语智商(VIQ)、理解测验和视觉分析得分均显著低于健康儿童(均 p<0.05)。在≥6 岁亚组中,OSAHS 患儿的 VIQ 和分类测验得分均显著低于健康对照组(均 p<0.05)。FIQ、VIQ 和操作智商(PIQ)与 AHI、OAHI 和最低夜间血氧饱和度(SO)均无相关性。值得注意的是,在<6 岁亚组的 OSAHS 患儿中,SO<90%的累积时间(p=0.046)和 SO<90%在总睡眠时间中的累积时间百分比(p=0.034)与 PIQ 呈显著负相关。
轻度至中度儿童 OSAHS 可能对认知功能产生不利影响,尤其是在幼儿(<6 岁)中。本研究可能会提高对儿童 OSAHS 相关认知功能障碍的认识,并倡导对儿童 OSAHS 进行早期干预。