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Executive Function in Pediatric Sleep-Disordered Breathing: A Meta-analysis

Published online by Cambridge University Press:  02 August 2016

Jonathan J. Mietchen
Affiliation:
Department of Psychology, Brigham Young University, Provo, Utah
David P. Bennett
Affiliation:
Neuroscience Center, Brigham Young University, Provo, Utah
Trevor Huff
Affiliation:
Neuroscience Center, Brigham Young University, Provo, Utah
Dawson W. Hedges
Affiliation:
Department of Psychology, Brigham Young University, Provo, Utah Neuroscience Center, Brigham Young University, Provo, Utah
Shawn D. Gale*
Affiliation:
Department of Psychology, Brigham Young University, Provo, Utah Neuroscience Center, Brigham Young University, Provo, Utah
*
Correspondence and reprint requests to: Shawn D. Gale, 1060 SWKT, Department of Psychology, Brigham Young University, Provo, Utah 84602. E-mail: shawn_gale@byu.edu

Abstract

Objectives: Evaluate the association between pediatric sleep-disordered breathing (SDB) and executive functioning. Methods: We searched multiple electronic databases for peer-reviewed journal articles related to pediatric SDB and executive functioning. We included studies that assessed SDB via polysomnography, included objective or questionnaire measures of executive function, and had an age-matched control group. Fourteen articles met inclusion criteria with a total sample of 1697 children ages 5 to 17 years (M=9.81 years; SD=0.34). We calculated an overall effect size for each of the five executive domains (vigilance, inhibition, working memory, shifting, and generativity) as well as effect sizes according to SDB severity: mild, moderate, severe. We also calculated effect sizes separately for objective and subjective questionnaires of executive functioning. Results: We found a medium effect size (−0.427) for just one of five executive function domains on objective neuropsychological measures (generativity). In contrast, effect sizes on all three executive domains measured via questionnaire data were significant, with effect sizes ranging from medium (−0.64) to large (−1.06). We found no difference between executive domains by severity of SDB. Conclusions: This meta-analysis of executive function separated into five domains in pediatric SDB suggested lower performance in generativity on objective neuropsychological measures. There were no differences associated with SDB severity. Questionnaire data suggested dysfunction across the three executive domains measured (inhibition, working memory, shifting). Overall, limited evidence suggested poorer performance in executive function in children with SDB according to objective testing, and subjective ratings of executive function suggested additional worsened performance. (JINS, 2016, 22, 839–850)

Type
Short Review
Copyright
Copyright © The International Neuropsychological Society 2016 

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