Neurocognitive performance and behavior before and after treatment for sleep-disordered breathing in children

Abstract

Neurocognitive and behavioral problems are increasingly reported in children with sleep-disordered breathing (SDB). The impact of treatment for SDB on neurocognition and behavior is, therefore, an issue of increasing importance. To date, there has been little consideration given to the quality of studies when reviewing associated neurocognitive and behavioral problems in children with SDB, and furthermore, there has been little systematic review of treatment outcomes. The aim of this review was to provide an up-to-date and critical review of the current literature. Findings indicate a specific pattern of neurocognitive problems in children with SDB; however, the pattern of behavioral problems is less clear. Very few studies were found to provide a rigorous investigation of posttreatment neurocognitive and behavior outcomes. Despite this, relatively consistent improvements in global intelligence, attention, and visual spatial ability are shown; however, persistent deficits in other domains are also evident. For behavior, problems of hyperactivity, aggression or conduct problems, and somatic complaints improve following treatment. In contrast, symptoms of anxiety and social problems less consistently improve. These findings should aid in the development of more targeted investigations and well-designed studies exploring both the causative mechanisms and the treatment response for neurocognitive and behavior problems in children with SDB.

Keywords: adenotonsillectomy; behavior; children; neurocognition; sleep-disordered breathing.

Figure 1

Pearson bivariate correlations (r) between SDB severity (obstructive apnea and hypopnea index) and neurocognitive performance domains among children with SDB at different ages (n = 18 for 3–4 years, n = 13 for 4–7 years, and n = 13 for 8–12 years). For further details on study design and results see Kohler et al.