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Sleep Med. 2017 Jun;34:170-178. doi: 10.1016/j.sleep.2017.02.028. Epub 2017 Mar 25.

Frequency of snoring, rather than apnea-hypopnea index, predicts both cognitive and behavioral problems in young children.

Author information

1
Department of Public Health Sciences, The University of Chicago, Chicago, IL, USA; Department of Psychology, Olivet Nazarene University, Bourbonnais, IL, USA. Electronic address: dsmith8@olivet.edu.
2
Department of Pediatrics, The University of Chicago, Chicago, IL, USA.
3
Department of Pediatrics, The University of Chicago, Chicago, IL, USA; Department of Psychiatry and Behavioral Neuroscience, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, Chicago, IL, USA.

Abstract

OBJECTIVE:

Primary snoring (PS) and obstructive sleep apnea (OSA) not only affect the quality of sleep in a large number of young children, but have also been repeatedly associated with a variety of behavioral and cognitive problems. However, little is known about the potentially differing relationships of behavioral and cognitive pathology within the sleep disordered breathing (SDB) spectrum.

METHOD:

This study examined data from an enriched for snoring community sample of 631 children aged between 4 and 10 years. Multivariate mixed models were used to assess the relationship between both snoring and the apnea-hypopnea index (AHI). Numerous cognitive and behavioral variables were used, while adjusting for several important demographic variables. These were followed by univariate analyses of individual measures and sensitivity analyses.

RESULTS:

Results indicated that snoring status is a significant predictor of general behavioral (p = 0.008) and cognitive (p = 0.013) domains, even after adjusting for baseline covariates and AHI severity. More frequent snoring was associated with poorer outcomes independent of AHI. However, AHI did not emerge as a significant predictor of the overall cognitive functioning domain (p = 0.377). Additionally, although AHI was a significant predictor of the general behavioral functioning domain (p = 0.008), the significance pattern and nature of its relationship with individual behavioral measures were inconsistent in post-hoc analyses.

CONCLUSION:

The findings of this study suggest that general behavioral and cognitive function may decline with greater snoring severity. Further, snoring should not simply be assumed to represent a lower severity level of SDB, but should be examined as a potential predictor of relevant outcomes.

KEYWORDS:

Apnea; Behavior; Children; Cognition; Sleep disordered breathing; Snoring

PMID:
28522088
PMCID:
PMC5532874
DOI:
10.1016/j.sleep.2017.02.028
[Indexed for MEDLINE]
Free PMC Article

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