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Changes in neuropsychological and behavioral functioning in children with and without obstructive sleep apnea following Tonsillectomy. | LitMetric

AI Article Synopsis

  • Adenotonsillectomy (AT) is the most common treatment for sleep disordered breathing (SDB) and often leads to improvements in cognitive and behavioral scores, though some children may experience ongoing deficits.
  • A 1-year follow-up study found significant improvements in sleep quality and parental reports of behavior after AT, but cognitive outcomes showed mixed results.
  • While many academic and attention-related measures improved, some aspects of cognitive performance actually declined, suggesting that AT may not fully resolve all behavioral and cognitive challenges in children with SDB.

Article Abstract

The most common treatment for sleep disordered breathing (SDB) is adenotonsillectomy (AT). Following AT, SDB resolves in most cases, and gains in cognitive and behavior scores are consistently reported, although persistent neuropsychological deficits or further declines also have been noted. This study presents results of the comprehensive 1-year follow-up neuropsychological examinations for children in the Washtenaw County Adenotonsillectomy Cohort I (95% return rate). After adjusting for normal developmental and practice-effect related changes in control children, significant improvements 1 year following AT were noted in polysomnography and sleepiness, as well as parental reports of behavior, although cognitive outcomes were mixed. Children undergoing AT with and without polysomnography-confirmed obstructive sleep apnea improved across a range of academic achievement measures, a measure of delayed visual recall, short-term attention/working memory, and executive functioning, along with parental ratings of behavior. On the other hand, measures of verbal abstraction ability, arithmetic calculations, visual and verbal learning, verbal delayed recall, sustained attention, and another measure of visual delayed recall demonstrated declines in ability, while other measures did not improve over time. These findings call into question the expectation that AT resolves most or all behavioral and cognitive difficulties in children with clinical, office-based diagnoses of SDB.

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Source
http://dx.doi.org/10.1017/S1355617711001743DOI Listing

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