Skip to main content
×
Home
    • Aa
    • Aa

Neuropsychological and behavioral functioning in children with and without obstructive sleep apnea referred for tonsillectomy

  • BRUNO GIORDANI (a1), ELISE K. HODGES (a1), KENNETH E. GUIRE (a2), DEBORAH L. RUZICKA (a3), JAMES E. DILLON (a4), ROBERT A. WEATHERLY (a5), SUSAN L. GARETZ (a5) and RONALD D. CHERVIN (a3)...
Abstract

Adenotonsillectomy (AT) is among the most common pediatric surgical procedures and is performed as often for obstructive sleep apnea (OSA) as for recurrent tonsillitis. This study compared behavioral, cognitive, and sleep measures in 27 healthy control children recruited from a university hospital-based pediatric general surgery clinic with 40 children who had OSA (AT/OSA+) and 27 children who did not have OSA (AT/OSA−) scheduled for AT. Parental ratings of behavior, sleep problems, and snoring, along with specific cognitive measures (i.e., short-term attention, visuospatial problem solving, memory, arithmetic) reflected greater difficulties for AT children compared with controls. Differences between the AT/OSA− and control groups were larger and more consistent across test measures than were those between the AT/OSA+ and control groups. The fact that worse outcomes were not clearly demonstrated for the AT/OSA+ group compared with the other groups was not expected based on existing literature. This counterintuitive finding may reflect a combination of factors, including age, daytime sleepiness, features of sleep-disordered breathing too subtle to show on standard polysomnography, and academic or environmental factors not collected in this study. These results underscore the importance of applying more sophisticated methodologies to better understand the salient pathophysiology of childhood sleep-disordered breathing. (JINS, 2008, 14, 571–581.)

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Neuropsychological and behavioral functioning in children with and without obstructive sleep apnea referred for tonsillectomy
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about sending content to Dropbox.

      Neuropsychological and behavioral functioning in children with and without obstructive sleep apnea referred for tonsillectomy
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about sending content to Google Drive.

      Neuropsychological and behavioral functioning in children with and without obstructive sleep apnea referred for tonsillectomy
      Available formats
      ×
Copyright
Corresponding author
Correspondence and reprint requests to: Bruno Giordani, Neuropsychology Section, Department of Psychiatry, University of Michigan, Suite C, 2101 Commonwealth Blvd., Ann Arbor, MI 48105-0716. E-mail: giordani@umich.edu
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

N.J. Ali , D. Pitson , & J.R. Stradling (1996). Sleep disordered breathing: Effects of adenotonsillectomy on behaviour and psychological functioning. European Journal of Pediatrics, 155, 5662.

K.H. Archbold , B. Giordani , D. Ruzicka , & R.D. Chervin (2004). Cognitive executive dysfunction in children with mild sleep apnea. Biological Research for Nursing, 5, 168176.

D. Bartlett , C. Rae , C. Thompson , K. Byth , D. Joffe , T. Enright , & R. Grunstei (2004). Hippocampal area metabolites relate to severity and cognitive function in OSA. Sleep Medicine, 5, 593596.

D.W. Beebe & D. Gozal (2002). Obstructive sleep apnea and the prefrontal cortex: Toward a comprehensive model linking nocturnal upper airway obstruction to daytime cognitive and behavioral deficits. Journal of Sleep Research, 11, 116.

S. Blunden , K. Lushington , B. Lorenzen , J. Martin , & D. Kennedy (2005). Neuropsychological and psychosocial functioning children with a history of snoring or behavioral sleep problems. Journal of Pediatrics, 146, 780786.

R.D. Chervin , D.F. Clarke , J.L. Huffman , E. Szymanski , D.L. Ruzicka , V. Miller , A.L. Nettles , M.R. Sowers , & B. Giordani (2003). School performance, race, and other correlates of sleep-disordered breathing in children. Sleep Medicine, 4, 2127.

R.D. Chervin , K.M. Hedger , J.E. Dillon , & K.J. Pituch (2000). Pediatric sleep questionnaire (PSQ): Validity and reliability of scale for sleep-disordered breathing, snoring, sleepiness and behavioral problems. Sleep Medicine, 1, 2132.

R.D. Chervin , D.L. Ruzicka , B.J. Giordani , R.A. Weatherly , J.E. Dillon , E.K. Hodges , C.L. Marcus , & K.E. Guire (2006). Sleep-disordered breathing, behavior, and cognition in children before and after adenotonsillectomy. Pediatrics, 117, e769e778.

R.D. Chervin , R.A. Weatherly , S.L. Garetz , D.L. Ruzicka , B.J. Giordani , E.K. Hodges , J.E. Dillon , & K.E. Guire (2007). Pediatric sleep questionnaire: Prediction of sleep apnea and outcomes. Archives of Otolaryngology Head and Neck Surgery, 133, 216222.

C.K. Cohen (1988). Statistical Power Analysis for the Behavioral Sciences (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum Associates.

J.L. Emancipator , A. Storfer-Isser , H.G. Taylor , C.L. Rosen , H.L. Kirchner , N.L. Johnson , A.M. Zambito , & S. Redline (2006). Variation of cognition and achievement with sleep-disordered breathing in full-term and preterm children. Archives of Pediatrics and Adolescent Medicine, 160, 203210.

D.J. Gottlieb , C. Chase , R.M. Vezina , T.C. Heeren , M.J. Corwin , S.E. Auerbach , D.E. Weese-Mayer , & S.M. Lesko (2004). Sleep-disordered breathing symptoms are associated with poorer cognitive function in 5-year-old children. Journal of Pediatrics, 145, 458464.

D.J. Gottlieb , R.M. Vezina , C. Chase , S.M. Lesko , T.C. Heeren , D.E. Weese-Mayer , S.H. Auerbach , & M.J. Corsin (2003). Symptoms of sleep-disordered breathing in 5-year-old children are associated with sleepiness and problem behaviors. Pediatrics, 112, 870877.

D. Gozal & D. Pope (2001). Snoring during early childhood and academic performance at ages thirteen to fourteen years. Pediatrics, 107, 13941399.

R.V. Grunau & M.D. Low (1987). Cognitive and task-related EEG correlates of arithmetic performance in adolescents. Journal of Clinical & Experimental Neuropsychology, 9, 563574.

J. Hibbert (1981). The occurrence of adenoidal signs and symptoms in normal children. Clinical Otolaryngology, 6, 97100.

R.O. Hopkins & K.Y. Haaland (2004). Neuropsychological and neuropathological effects of anoxic or ischemic induced brain injury. Journal of the International Neuropsychological Society, 10, 957961.

A. Kales , A.B. Caldwell , R.J. Cadieux , A. Vela-Bueno , L.G. Ruch , & S.D. Mayes (1985). Severe obstructive sleep apnea—II: Associated psychopathology and psychosocial consequences. Journal of Chronic Diseases, 38, 427434.

J.D. Kennedy , S. Blunden , C. Hirte , D.W. Parsons , A.J. Martin , E. Crowe , D. Williams , Y. Pamula , & K. Lushington (2004). Reduced neurocognition in children who snore. Pediatric Pulmonology, 37, 330337.

D.S. Lewin , R.C. Rosen , S.J. England , & R.E. Dahl (2002). Preliminary evidence of behavioral and cognitive sequelae of obstructive sleep apnea in children. Sleep Medicine, 3, 513.

C.L. Marcus & G.M. Loughlin (1996). Obstructive sleep apnea in children. Seminars in Pediatric Neurology, 3, 2328.

R.B. Mitchell & J. Kelly (2005). Child behavior after adenotonsillectomy for obstructive sleep apnea syndrome. The Laryngoscope, 115, 20512055.

H.E. Montgomery-Downs , V.M. Crabtree , & D. Gozal (2005). Cognition, sleep and respiration in at-risk children treated for obstructive sleep apnoea. European Respiratory Journal, 25, 336342.

M. Morrell , D. McRobbie , R. Quest , A. Cummin , R. Ghiassi , & D. Corfield (2004). Changes in brain morphology associated with obstructive sleep apnea. Sleep Medicine, 4, 451454.

S. Naismith , V. Winter , H. Gotsopoulos , I. Hickie , & P. Cistulli (2004). Neurobehavioral functioning in obstructive sleep apnea: Differential effects of sleep quality, hypoxemia and subjective sleepiness. Journal of Clinical and Experimental Neuropsychology, 26, 4354.

L.M. O'Brien , C.R. Holbrook , C.B. Mervis , C.J. Klaus , J.L. Bruner , T.J. Raffield , J. Rutherford , R.C. Mehl , M. Wang , A. Tuell , B.C. Hume , & D. Gozal (2003). Sleep and neurobehavioral characteristics of 5- to 7-year-old children with parentally reported symptoms of attention-deficit/hyperactivity disorder. Pediatrics, 111, 554.

L.M. O'Brien , C.B. Mervis , C.R. Holbrook , J.L. Bruner , N.H. Smith , N. McNally , M.C. McClimment , & D. Gozal (2004a). Neurobehavioral correlates of sleep-disordered breathing in children. Journal of Sleep Research, 13, 165172.

J. Owens , A. Spirito , A.C. Marcotte , M. McGuinn , & L. Berkelhammer (2000). Neuropsychological and behavioral correlates of obstructive sleep apnea syndrome in children: A preliminary study. Sleep and Breathing, 4, 6768.

C.L. Rosen , A. Storfer-Isser , H.G. Taylor , H.L. Kirchner , J.L. Emancipator , & S. Redline (2004). Increased behavioral morbidity in school-aged children with sleep-disordered breathing. Pediatrics, 114, 4449.

C.F. Salorio , D.A. Whitel , J. Piccirillo , S.P. Duntley , & M.L. Uhles (2002). Learning, memory, and executive control in individuals with obstructive sleep apnea syndrome. Journal of Clinical and Experimental Neuropsychology, 24, 93100.

K.A. Sotaniemi (1980). Brain damage and neurological outcome after open-heart surgery. Journal of Neurology, Neurosurgery, and Psychiatry, 43, 127135.

P. Stiers , B.M. van den Hout , M. Haers , R. Vanderkelen , L.S. de Vries , O. van Nieuwenhuizen , & E. Vandenbussche (2001). The variety of visual perceptual impairments in pre-school children with perinatal brain damage. Brain and Development, 23, 333348.

J.R. Stradling , G. Thomas , A.H. Warley , P. Williams , & A. Freeland (1990). Effect of adenotonsillectomy on nocturnal hypoxaemia, sleep disturbance and symptoms in snoring children. Lancet, 335, 249253.

G.A Troup , J.L. Bradshaw , & N.C. Nettleton (1983). The lateralization of arithmetic and number processing: A review. International Journal of Neuroscience, 19, 231241.

M.S. Urschitz , A. Guenther , E. Eggebrecht , J. Wolff , P.M. Urschitz-Duprat , M. Schlaud , & C.F. Pets (2003). Snoring, intermittent hypoxia and academic performance in primary school children. American Journal of Respiratory Critical Care Medicine, 168, 464468.

R.A. Weatherly , E.F. Mai , D.L. Ruzicka , & R.D. Chervin (2003). Identification and evaluation of obstructive sleep apnea prior to adenotonsillectomy in children: A survey of practice patterns. Sleep Medicine, 4, 297307.

R.A. Weatherly , D.L. Ruzicka , D.J. Marriott , & R.D. Chervin (2004). Polysomnography in children scheduled for adenotonsillectomy. Otolaryngology—Head and Neck Surgery, 131, 727731.

G. Zoccoli , A.M. Walker , P. Lenzi , & C. Franzini (2002). The cerebral circulation during sleep: Regulation mechanisms and functional implications. Sleep Medicine Reviews, 6, 443.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Journal of the International Neuropsychological Society
  • ISSN: 1355-6177
  • EISSN: 1469-7661
  • URL: /core/journals/journal-of-the-international-neuropsychological-society
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords:

Metrics

Full text views

Total number of HTML views: 3
Total number of PDF views: 24 *
Loading metrics...

Abstract views

Total abstract views: 96 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 28th May 2017. This data will be updated every 24 hours.