Sleep-disordered breathing symptoms are associated with poorer cognitive function in 5-year-old children

Daniel J. Gottlieb*, Cynthia Chase, Richard M. Vezina, Timothy C. Heeren, Michael J. Corwin, Sanford H. Auerbach, Debra E. Weese-Mayer, Samuel M. Lesko

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

204 Scopus citations


Objective To assess the relation of sleep-disordered breathing (SDB) symptoms in children to neurocognitive function. Study design A cross-sectional, population-based study of 205 5-year-old children. A parent-completed questionnaire was used to ascertain SDB symptoms, defined as frequent snoring, loud or noisy breathing during sleep, or witnessed sleep apnea. Polysomnography (PSG) data were available in 85% of children. Standardized neurocognitive tests were administered by a trained psychometrist unaware of the children's SDB status. Children with (n=61) and without SDB symptoms were compared using analysis of variance to adjust for demographic and respiratory health variables. Results Children with SDB symptoms scored significantly lower than those without SDB symptoms on tests of executive function (95.5 vs 99.9 on NEPSY Attention/Executive Core Domain, P=.02; 10.4 vs 11.2 on Wechsler Preschool and Primary Scale of Intelligence, Revised [WPPSI-R] Animal Pegs test, P=.03), memory (96.8 vs 103.0 on NEPSY Memory Domain, P=.02), and general intellectual ability (105.9 vs 111.7 on WPPSI-R Full Scale IQ, P=.02). There were no significant differences on a computerized continuous performance task. These findings persisted when children with PSG evidence of obstructive sleep apnea (OSA) were excluded from analysis. Conclusion Even in the absence of OSA, SDB symptoms are associated with poorer executive function and memory skills and lower general intelligence in 5-year-old children.

Original languageEnglish (US)
Pages (from-to)458-464
Number of pages7
JournalJournal of Pediatrics
Issue number4
StatePublished - Oct 2004


  • ADHD
  • AHI
  • Apnea-Hypopnea Index
  • Attention deficit-hyperactivity disorder
  • CPRS
  • CPT
  • Conners' Parent Rating Scale, Long Form
  • Continuous performance task
  • FYFQ
  • Five-year follow-up questionnaire
  • ICPS
  • Infant Care Practices Study

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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