Neuropsychological and behavioral functioning in children with and without obstructive sleep apnea referred for tonsillectomy
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-b...
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| Published in | Journal of the International Neuropsychological Society Vol. 14; no. 4; pp. 571 - 581 |
|---|---|
| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
New York, USA
Cambridge University Press
01.07.2008
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1355-6177 1469-7661 1469-7661 |
| DOI | 10.1017/S1355617708080776 |
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| 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.) |
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| AbstractList | 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. 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.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. 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.) 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.) 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. 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.) 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.) [PUBLICATION ABSTRACT] |
| Author | GUIRE, KENNETH E. DILLON, JAMES E. HODGES, ELISE K. CHERVIN, RONALD D. GARETZ, SUSAN L. GIORDANI, BRUNO RUZICKA, DEBORAH L. WEATHERLY, ROBERT A. |
| AuthorAffiliation | 1 Neuropsychology Section, Department of Psychiatry, University of Michigan, Ann Arbor, Michigan 2 Biostatics Department, School of Public Health, University of Michigan, Ann Arbor, Michigan 4 MDCHC/Corrections and Division of Child and Adolescent Psychiatry, Department of Psychiatry, University of Michigan, Ann Arbor, Michigan 5 Otorhinolaryngology Department, University of Michigan, Ann Arbor, Michigan 3 Sleep Medicine, Neurology Department, University of Michigan, Ann Arbor, Michigan |
| AuthorAffiliation_xml | – name: 5 Otorhinolaryngology Department, University of Michigan, Ann Arbor, Michigan – name: 4 MDCHC/Corrections and Division of Child and Adolescent Psychiatry, Department of Psychiatry, University of Michigan, Ann Arbor, Michigan – name: 3 Sleep Medicine, Neurology Department, University of Michigan, Ann Arbor, Michigan – name: 1 Neuropsychology Section, Department of Psychiatry, University of Michigan, Ann Arbor, Michigan – name: 2 Biostatics Department, School of Public Health, University of Michigan, Ann Arbor, Michigan |
| Author_xml | – sequence: 1 givenname: BRUNO surname: GIORDANI fullname: GIORDANI, BRUNO email: giordani@umich.edu organization: Neuropsychology Section, Department of Psychiatry, University of Michigan, Ann Arbor, Michigan – sequence: 2 givenname: ELISE K. surname: HODGES fullname: HODGES, ELISE K. organization: Neuropsychology Section, Department of Psychiatry, University of Michigan, Ann Arbor, Michigan – sequence: 3 givenname: KENNETH E. surname: GUIRE fullname: GUIRE, KENNETH E. organization: Biostatics Department, School of Public Health, University of Michigan, Ann Arbor, Michigan – sequence: 4 givenname: DEBORAH L. surname: RUZICKA fullname: RUZICKA, DEBORAH L. organization: Sleep Medicine, Neurology Department, University of Michigan, Ann Arbor, Michigan – sequence: 5 givenname: JAMES E. surname: DILLON fullname: DILLON, JAMES E. organization: MDCHC/Corrections and Division of Child and Adolescent Psychiatry, Department of Psychiatry, University of Michigan, Ann Arbor, Michigan – sequence: 6 givenname: ROBERT A. surname: WEATHERLY fullname: WEATHERLY, ROBERT A. organization: Otorhinolaryngology Department, University of Michigan, Ann Arbor, Michigan – sequence: 7 givenname: SUSAN L. surname: GARETZ fullname: GARETZ, SUSAN L. organization: Otorhinolaryngology Department, University of Michigan, Ann Arbor, Michigan – sequence: 8 givenname: RONALD D. surname: CHERVIN fullname: CHERVIN, RONALD D. organization: Sleep Medicine, Neurology Department, University of Michigan, Ann Arbor, Michigan |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/18577286$$D View this record in MEDLINE/PubMed |
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| Keywords | Tonsillitis Neuropsychology Adenotonsillectomy Polysomnography Sleep-disordered breathing Snoring |
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Annals of Otology, Rhinology, and Laryngology doi: 10.1177/000348949009900305 |
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| SubjectTerms | Achievement Adenoidectomy Adenotonsillectomy Behavior Child Child Behavior Disorders - diagnosis Child Behavior Disorders - psychology Child, Preschool Children & youth Cognition Disorders - diagnosis Cognition Disorders - psychology Cross-Sectional Studies Data collection Female Humans Male Neuropsychological Tests Neuropsychology Parents & parenting Personality Assessment Polysomnography Postoperative Complications - diagnosis Postoperative Complications - psychology Referral and Consultation Sleep apnea Sleep Apnea, Obstructive - diagnosis Sleep Apnea, Obstructive - surgery Sleep-disordered breathing Snoring Studies Tonsillectomy Tonsillitis Urban schools |
| Title | Neuropsychological and behavioral functioning in children with and without obstructive sleep apnea referred for tonsillectomy |
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