Cognitive and behavioral effects of obstructive sleep apnea in toddlers with Down syndrome.

摘要

The purpose of this study was to evaluate the impact of obstructive sleep apnea (OSA) on the cognitive, motor, behavioral and adaptive functioning of toddlers with Down syndrome. Participants were 18 toddlers with Down syndrome between the ages of 15 and 47 months of age (M = 29.56, SD = 8.62) without histories of cardiac defects. Participants were evaluated on standardized measures of cognitive, motor, behavioral and adaptive functioning and were screened for presence of OSA by overnight pulse oximetry. OSA status was determined by two methods. The empirical method utilized the oxygen desaturation index to determine OSA status, resulting in an OSA group with n = 13 and a non-OSA group with n = 5. The clinical method utilized physician evaluation of the oximetry studies to determine OSA status, resulting in an OSA group with n = 4 and a non-OSA group with n = 14. The empirically derived groups did not differ on any of the measures of child functioning. The clinically derived OSA group performed significantly more poorly than the non-OSA group on the adaptive behavior measure (t = −3.21, p = 0.003). Correlational analyses of the oxygen desaturation index with each of the measures of child functioning for the entire group of participants indicated that severity of oxygen desaturation was significantly negatively related to both cognitive and adaptive behavioral functioning. These data suggest that OSA has a significant impact on the cognitive and adaptive behavioral functioning of these already developmentally compromised children. Thus, identification and treatment of OSA in young children with Down syndrome may be an important area of focus for developmental advancement in this population. The implications of the varying results obtained by the different methods used to determine OSA status are discussed.