Objective:Pediatric sleep-disordered breathing(SDB)has a disproportionatel y high prevalence in children who were preterm infants(preterm children)and is associated with behavioral comorbidity.Exposure to intermittent hypoxemia and sleep disruption may contribute to cognitive impairment.We quantified the assoc iation of SDB with cognition and achievement and determined whether preterm chil dren are at a differentially increased risk for SDB-related impairments.Design :Cross-sectional analyses.Setting:Urban community.Participants:Eight hundr ed thirty-five children,aged 8 to 11 years.Intervention(s):None.Main Outcom e Measures:Scores on the Peabody Picture Vocabulary Test-Revised,Kaufman Asse ssment Battery for Children,and Continuous Performance Test.Results:One hundr ed sixty-four children had SDB.In unadjusted analyses,children with SDB had p oorer scores on almost all tests of cognition and achievement.Group differences were attenuated after adjusting for socioeconomic status;in these analyses,ch ildren with SDB scored lower on the Peabody Picture Vocabulary Test-Revised(me an±SE score,100.5±1.4 vs 103.6±0.7;P=.04),and the Kaufman Assessment Batte ry for Children riddles and triangles subscales.Associations were stronger in p reterm than in full-term children.Of the sleep measures,snoring history was m ost strongly correlated with indices of cognition and achievement.Conclusions:Although moderate group differences were observed for almost all cognitive measu res,an attenuation of effects was observed once socioeconomic status was consid ered.The deficits in selective measures of academic abilities,language compreh ension,and planning and organizational skills suggest a negative impact of SDB on achievement and cognition.Stronger associations in preterm children suggest the importance of screening for snoring,a good predictor of cognitive function in this population.
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