NEUROCOGNITION RELATIONSHIP TO AHI IN PRE-SCHOOL CHILDREN WITH POSITIVE PSQ

Oral Session 2
Saturday, April 28, 2018 | 4:00pm-5:30pm | Room 342B

4:45pm-5:00pm
NEUROCOGNITION RELATIONSHIP TO AHI IN PRE-SCHOOL CHILDREN WITH POSITIVE PSQ

Authors:
Helen Heussler (Australia)*
Jasneek Chawla (Australia)
Hannah Burns (Australia)
Robert Black (Australia)
Karen Waters (Australia)
Kurt Lushington (Australia)
Carolyn Dakin (Australia)
Margaret-Anne Harris (Australia)

Introduction

Sleep disordered breathing (SDB) is common in children. Primary snoring (PS) represents mild disease for children who snore, but have few or no events on polysomnography (PSG): obstructive apnoea hypopnoea index (OAHI) <1/hr. In recent years a growing body of evidence suggests that school-aged children with PS are at risk of cognitive and behavioural deficits. Distinction between PS and OSA in decision making has been based on OAHI but it is unclear that this is relevant in young children. Whether similar deficits are also evident in pre-school children with PS and OSA remains to be fully tested.

Materials and methods

The Pre-School OSA Tonsillectomy Adenoidectomy (POSTA) Study is a multi-centre randomised controlled trial evaluating whether IQ deficits in pre-school children with mild-moderate OSA (OAHI 1-10/hr) are corrected by adenotonsillectomy. We are recruiting otherwise healthy children with a history of snoring, who are suitable for adenotonsillectomy. Children aged 3-5y referred to ENT for assessment of OSA symptoms were screened using the paediatric sleep questionnaire (PSQ). Neurocognitive assessment was assessed using the Woodcock- Johnson III—a cognitive assessment instrument validated in children aged 3-7 years. Executive functioning was measured by the BRIEF-P. We present baseline data comparing children recruited to POSTA, with OAHI 1-10/hr against children who underwent baseline cognitive and executive function assessments but met criteria for PS [OAHI <1/hr].

Results

During recruitment, a group of children with positive PSQ scores for OSA met PSG criteria for PS, but also underwent neurocognitive testing. Data for 88 children are presented, with age 48.5 (8.0) months (mean (SD), range 31-69 months) and BMI 16.3 kgs/m2(range 13.5-24.2kgs/m2). The WJIII-GIA scores were normally distributed (104.6 (13.9), range 70-143). Thirty children had PS (n=30) and 35 had mild-moderate OSA. (n=35). Comparing the group with PS against those with OSA, we found no differences for BMI, age, or general cognitive functioning (GIA scores). The OAHI and PS groups had different tonsil size by clinical assessment (p=0.007). There was a non-significant trend for children with higher BMI to have higher OAHI. Higher BMI and larger tonsil size predicted higher OAHI (p=0.002).

Conclusions

Neurocognitive function was not different between pre-school children with PS compared to those with mild to moderate OSA. In pre-school children, OAHI results alone may not be indicative of cognitive deficits and the need for treatment.

Acknowledgements

This project was funded by
1. Garnett Passe and Rodney Williams Foundation
2. National Health and Medical research Council Australia. # APP1049788

Thanks to the many families and young children who participated in the Trial