Centre for Innovative Research Across the Lifecourse, Coventry University , Coventry, UK.
Department of Paediatric Respiratory Medicine, Sheffield Children's NHS Foundation Trust , Sheffield, UK.
Behav Sleep Med. 2020 Sep-Oct;18(5):611-621. doi: 10.1080/15402002.2019.1641501. Epub 2019 Jul 16.
OBJECTIVE/BACKGROUND: Children with Down syndrome (DS) commonly experience difficulties with executive function (EF). They are also vulnerable to obstructive sleep apnoea (OSA). OSA is associated with EF deficits in typically developing children. A recent study reported an association between OSA and cognitive deficits in 38 school-aged children with DS. We experimentally investigated EF behaviours in young children with DS, and their association with OSA.
Children with DS were recruited to take part in a larger study of OSA (N = 202). Parents of 80 children (50 male) aged 36 to 71 months ( = 56.90, = 10.19 months) completed the Behavior Rating Inventory of Executive Function - Preschool Version (BRIEF-P). Of these 80 children, 69 were also successfully studied overnight with domiciliary cardiorespiratory polygraphy to diagnose OSA.
Obstructive apnoea/hypopnoea index was in the normal range (0-1.49/h) for 28 children but indicated OSA (≥1.5/h) in 41 children. Consistent with previous research, we found a large effect for children experiencing particular weaknesses in working memory, planning and organising, whilst emotional control was a relative strength. OSA was associated with poorer working memory (β = .23, R2 = .05, = .025), emotional control (β = .20, R2 = .04, = .047) and shifting (β = .24, R2 = .06, = .023).
Findings suggest that known EF difficulties in DS are already evident at this young age. Children with DS already have limited cognitive reserve and can ill afford additional EF deficit associated with OSA. OSA is amenable to treatment and should be actively treated in these children to promote optimal cognitive development.
目的/背景：唐氏综合征（DS）患儿通常存在执行功能（EF）困难。他们也容易患阻塞性睡眠呼吸暂停（OSA）。在典型发育儿童中，OSA 与 EF 缺陷有关。最近的一项研究报告称，38 名学龄 DS 患儿的 OSA 与认知缺陷之间存在关联。我们在年轻的 DS 患儿中进行了 EF 行为的实验研究，并研究了它们与 OSA 的关系。
招募了患有 DS 的儿童参加一项更大规模的 OSA 研究（N=202）。80 名儿童（50 名男性）的父母年龄为 36 至 71 个月（=56.90，=10.19 个月），完成了行为评定量表 - 学前版（BRIEF-P）。在这 80 名儿童中，69 名儿童还成功地接受了家庭心肺多导睡眠图检查以诊断 OSA。
28 名儿童的阻塞性呼吸暂停/低通气指数在正常范围内（0-1.49/h），而 41 名儿童则表明存在 OSA（≥1.5/h）。与之前的研究一致，我们发现，在工作记忆、计划和组织方面存在特殊弱点的儿童的影响较大，而情绪控制是相对优势。OSA 与较差的工作记忆（β=0.23，R2=0.05，=0.025）、情绪控制（β=0.20，R2=0.04，=0.047）和转移（β=0.24，R2=0.06，=0.023）相关。
研究结果表明，DS 患儿的已知 EF 困难在这个年龄已经很明显。DS 患儿的认知储备已经有限，无法承受与 OSA 相关的额外 EF 缺陷。OSA 是可以治疗的，应该积极治疗这些儿童，以促进最佳认知发育。
