Jasneek Chawla1,2,3, Margaret-Anne Harris4,5,6, Robert Black4,5,6, Marie-Josee Leclerc4,5,6, Hannah Burns4,5,6, Karen A Waters7,8, Anne Bernard9, Kurt Lushington10,11, Helen Heussler4,5,6. 1. Department of Respiratory & Sleep Medicine, The Queensland Children's Hospital, Level 5a, 501 Stanley Street, South Brisbane, Queensland, 4101, Australia. Jasneek.chawla@health.qld.gov.au. 2. The Mater Research Institute, The University of Queensland, Brisbane, Australia. Jasneek.chawla@health.qld.gov.au. 3. Faculty of Medicine, The University of Queensland, Brisbane, Australia. Jasneek.chawla@health.qld.gov.au. 4. Department of Respiratory & Sleep Medicine, The Queensland Children's Hospital, Level 5a, 501 Stanley Street, South Brisbane, Queensland, 4101, Australia. 5. The Mater Research Institute, The University of Queensland, Brisbane, Australia. 6. Faculty of Medicine, The University of Queensland, Brisbane, Australia. 7. The Children's Hospital at Westmead, Sydney, Australia. 8. The University of Sydney, Sydney, Australia. 9. QFAB Bioinformatics, Institute for Molecular Bioscience, University of Queensland, Brisbane, Australia. 10. Women and Children's Hospital, Adelaide, South Australia, Australia. 11. The University of South Australia, Adelaide, South Australia, Australia.
Abstract
PURPOSE: Sleep disordered breathing (SDB) in children is commonly described as a continuum from primary snoring (PS) to obstructive sleep apnea (OSA), based on apnea indices from polysomnography (PSG). This study evaluated the difference in neurocognitive and behavioral parameters, prior to treatment, in symptomatic pre-school children with PSG-diagnosed OSA and PS. METHODS: All children had positive Pediatric Sleep Questionnaire (PSQ) results and were deemed suitable for adenotonsillectomy by an ENT surgeon. Neurocognitive and behavioral data were analyzed in pre-school children at recruitment for the POSTA study (The Pre-School OSA Tonsillectomy Adenoidectomy Study). Data were compared between PS and OSA groups, with Obstructive Apnea-Hypopnea Index, OAHI < 1/h or 1-10/h, respectively. RESULTS: Ninety-one children were enrolled, including 52 with OSA and 39 with PS. Distribution of IQ (using Brief Intellectual Ability, BIA) was slightly skewed towards higher values compared with the reference population. No significant differences were found in neurocognitive or behavioral parameters for children with OSA versus those with PS. DISCUSSION: Neurocognitive and behavioral parameters were similar in pre-school children symptomatic for OSA, regardless of whether or not PSG diagnosed PS or OSA. Despite having identical symptoms, children with PS on PSG are often treated conservatively, whereas those with OSA on PSG are considered for adenotonsillectomy. This study demonstrates that, regardless of whether or not PS or OSA is diagnosed on PSG, symptoms, neurocognition, and behavior are identical in these groups. We conclude that symptoms and behavioral disturbances should be considered in addition to OAHI when determining the need for treatment. TRIAL REGISTRATION: Australian and New Zealand Clinical Trials registration number ACTRN12611000021976.
PURPOSE: Sleep disordered breathing (SDB) in children is commonly described as a continuum from primary snoring (PS) to obstructive sleep apnea (OSA), based on apnea indices from polysomnography (PSG). This study evaluated the difference in neurocognitive and behavioral parameters, prior to treatment, in symptomatic pre-school children with PSG-diagnosed OSA and PS. METHODS: All children had positive Pediatric Sleep Questionnaire (PSQ) results and were deemed suitable for adenotonsillectomy by an ENT surgeon. Neurocognitive and behavioral data were analyzed in pre-school children at recruitment for the POSTA study (The Pre-School OSA Tonsillectomy Adenoidectomy Study). Data were compared between PS and OSA groups, with Obstructive Apnea-Hypopnea Index, OAHI < 1/h or 1-10/h, respectively. RESULTS: Ninety-one children were enrolled, including 52 with OSA and 39 with PS. Distribution of IQ (using Brief Intellectual Ability, BIA) was slightly skewed towards higher values compared with the reference population. No significant differences were found in neurocognitive or behavioral parameters for children with OSA versus those with PS. DISCUSSION: Neurocognitive and behavioral parameters were similar in pre-school children symptomatic for OSA, regardless of whether or not PSG diagnosed PS or OSA. Despite having identical symptoms, children with PS on PSG are often treated conservatively, whereas those with OSA on PSG are considered for adenotonsillectomy. This study demonstrates that, regardless of whether or not PS or OSA is diagnosed on PSG, symptoms, neurocognition, and behavior are identical in these groups. We conclude that symptoms and behavioral disturbances should be considered in addition to OAHI when determining the need for treatment. TRIAL REGISTRATION: Australian and New Zealand Clinical Trials registration number ACTRN12611000021976.