Obstructive sleep apnoea contributes to executive function impairment in young children with Down syndrome

Anna Joyce, Heather E Elphick, Michael Farquhar, Paul Gringras, Hazel Evans, Romola S Bucks, Jana Kreppner, Ruth Kingshott, Jane Martin, Janine Reynolds, Carla Rush, Johanna Gavlak, Catherine M. Hill

    Research output: Contribution to journalArticle

    Abstract

    Objective/Background: Children with Down syndrome (DS) commonly experience difficulties with executive function (EF). They are also vulnerable to obstructive sleep apnoea (OSA). OSA is associated with EF deficits in typically developing children. A recent study reported an association between OSA and cognitive deficits in 38 school-aged children with DS. We experimentally investigated EF behaviours in young children with DS, and their association with OSA.
    Participants and Methods: Children with DS were recruited to take part in a larger study of OSA (N=202). Parents of 80 children (50 male) aged 36 to 71 months (M = 56.90, SD = 10.19 months) completed the Behavior Rating Inventory of Executive Function - Preschool Version (BRIEF-P). Of these 80 children, 69 were also successfully studied overnight with domiciliary cardiorespiratory polygraphy to diagnose OSA.
    Results: Obstructive apnoea/hypopnoea index was in the normal range (0-1.49/h) for 28 children but indicated OSA (≥1.5/h) in 41 children. Consistent with previous research, we found a large effect for children experiencing particular weaknesses in working memory, planning and organising, whilst emotional control was a relative strength. OSA was associated with poorer working memory (β=.23, R2=.05, p=.025), emotional control (β=.20, R2=.04, p=.047) and shifting (β=.24, R2=.06, p=.023). Conclusions: Findings suggest that known EF difficulties in DS are already evident at this young age. Children with DS already have limited cognitive reserve and can ill afford additional EF deficit associated with OSA. OSA is amenable to treatment and should be actively treated in these children to promote optimal cognitive development.
    Original languageEnglish
    Pages (from-to)(In-Press)
    JournalBehavioral Sleep Medicine
    Volume(In-Press)
    Early online date16 Jul 2019
    DOIs
    Publication statusE-pub ahead of print - 16 Jul 2019

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    Executive Function
    Obstructive Sleep Apnea
    Down Syndrome
    Short-Term Memory
    Cognitive Reserve
    Apnea
    Reference Values
    Parents

    Cite this

    Joyce, A., Elphick, H. E., Farquhar, M., Gringras, P., Evans, H., Bucks, R. S., ... Hill, C. M. (2019). Obstructive sleep apnoea contributes to executive function impairment in young children with Down syndrome. Behavioral Sleep Medicine, (In-Press), (In-Press). https://doi.org/10.1080/15402002.2019.1641501

    Obstructive sleep apnoea contributes to executive function impairment in young children with Down syndrome. / Joyce, Anna; Elphick, Heather E; Farquhar, Michael; Gringras, Paul; Evans, Hazel; Bucks, Romola S; Kreppner, Jana; Kingshott, Ruth; Martin, Jane; Reynolds, Janine; Rush, Carla; Gavlak, Johanna; Hill, Catherine M.

    In: Behavioral Sleep Medicine, Vol. (In-Press), 16.07.2019, p. (In-Press).

    Research output: Contribution to journalArticle

    Joyce, A, Elphick, HE, Farquhar, M, Gringras, P, Evans, H, Bucks, RS, Kreppner, J, Kingshott, R, Martin, J, Reynolds, J, Rush, C, Gavlak, J & Hill, CM 2019, 'Obstructive sleep apnoea contributes to executive function impairment in young children with Down syndrome' Behavioral Sleep Medicine, vol. (In-Press), pp. (In-Press). https://doi.org/10.1080/15402002.2019.1641501
    Joyce, Anna ; Elphick, Heather E ; Farquhar, Michael ; Gringras, Paul ; Evans, Hazel ; Bucks, Romola S ; Kreppner, Jana ; Kingshott, Ruth ; Martin, Jane ; Reynolds, Janine ; Rush, Carla ; Gavlak, Johanna ; Hill, Catherine M. / Obstructive sleep apnoea contributes to executive function impairment in young children with Down syndrome. In: Behavioral Sleep Medicine. 2019 ; Vol. (In-Press). pp. (In-Press).
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    abstract = "Objective/Background: Children with Down syndrome (DS) commonly experience difficulties with executive function (EF). They are also vulnerable to obstructive sleep apnoea (OSA). OSA is associated with EF deficits in typically developing children. A recent study reported an association between OSA and cognitive deficits in 38 school-aged children with DS. We experimentally investigated EF behaviours in young children with DS, and their association with OSA.Participants and Methods: Children with DS were recruited to take part in a larger study of OSA (N=202). Parents of 80 children (50 male) aged 36 to 71 months (M = 56.90, SD = 10.19 months) completed the Behavior Rating Inventory of Executive Function - Preschool Version (BRIEF-P). Of these 80 children, 69 were also successfully studied overnight with domiciliary cardiorespiratory polygraphy to diagnose OSA. Results: Obstructive apnoea/hypopnoea index was in the normal range (0-1.49/h) for 28 children but indicated OSA (≥1.5/h) in 41 children. Consistent with previous research, we found a large effect for children experiencing particular weaknesses in working memory, planning and organising, whilst emotional control was a relative strength. OSA was associated with poorer working memory (β=.23, R2=.05, p=.025), emotional control (β=.20, R2=.04, p=.047) and shifting (β=.24, R2=.06, p=.023). Conclusions: Findings suggest that known EF difficulties in DS are already evident at this young age. Children with DS already have limited cognitive reserve and can ill afford additional EF deficit associated with OSA. OSA is amenable to treatment and should be actively treated in these children to promote optimal cognitive development.",
    author = "Anna Joyce and Elphick, {Heather E} and Michael Farquhar and Paul Gringras and Hazel Evans and Bucks, {Romola S} and Jana Kreppner and Ruth Kingshott and Jane Martin and Janine Reynolds and Carla Rush and Johanna Gavlak and Hill, {Catherine M.}",
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    AU - Joyce, Anna

    AU - Elphick, Heather E

    AU - Farquhar, Michael

    AU - Gringras, Paul

    AU - Evans, Hazel

    AU - Bucks, Romola S

    AU - Kreppner, Jana

    AU - Kingshott, Ruth

    AU - Martin, Jane

    AU - Reynolds, Janine

    AU - Rush, Carla

    AU - Gavlak, Johanna

    AU - Hill, Catherine M.

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    N2 - Objective/Background: Children with Down syndrome (DS) commonly experience difficulties with executive function (EF). They are also vulnerable to obstructive sleep apnoea (OSA). OSA is associated with EF deficits in typically developing children. A recent study reported an association between OSA and cognitive deficits in 38 school-aged children with DS. We experimentally investigated EF behaviours in young children with DS, and their association with OSA.Participants and Methods: Children with DS were recruited to take part in a larger study of OSA (N=202). Parents of 80 children (50 male) aged 36 to 71 months (M = 56.90, SD = 10.19 months) completed the Behavior Rating Inventory of Executive Function - Preschool Version (BRIEF-P). Of these 80 children, 69 were also successfully studied overnight with domiciliary cardiorespiratory polygraphy to diagnose OSA. Results: Obstructive apnoea/hypopnoea index was in the normal range (0-1.49/h) for 28 children but indicated OSA (≥1.5/h) in 41 children. Consistent with previous research, we found a large effect for children experiencing particular weaknesses in working memory, planning and organising, whilst emotional control was a relative strength. OSA was associated with poorer working memory (β=.23, R2=.05, p=.025), emotional control (β=.20, R2=.04, p=.047) and shifting (β=.24, R2=.06, p=.023). Conclusions: Findings suggest that known EF difficulties in DS are already evident at this young age. Children with DS already have limited cognitive reserve and can ill afford additional EF deficit associated with OSA. OSA is amenable to treatment and should be actively treated in these children to promote optimal cognitive development.

    AB - Objective/Background: Children with Down syndrome (DS) commonly experience difficulties with executive function (EF). They are also vulnerable to obstructive sleep apnoea (OSA). OSA is associated with EF deficits in typically developing children. A recent study reported an association between OSA and cognitive deficits in 38 school-aged children with DS. We experimentally investigated EF behaviours in young children with DS, and their association with OSA.Participants and Methods: Children with DS were recruited to take part in a larger study of OSA (N=202). Parents of 80 children (50 male) aged 36 to 71 months (M = 56.90, SD = 10.19 months) completed the Behavior Rating Inventory of Executive Function - Preschool Version (BRIEF-P). Of these 80 children, 69 were also successfully studied overnight with domiciliary cardiorespiratory polygraphy to diagnose OSA. Results: Obstructive apnoea/hypopnoea index was in the normal range (0-1.49/h) for 28 children but indicated OSA (≥1.5/h) in 41 children. Consistent with previous research, we found a large effect for children experiencing particular weaknesses in working memory, planning and organising, whilst emotional control was a relative strength. OSA was associated with poorer working memory (β=.23, R2=.05, p=.025), emotional control (β=.20, R2=.04, p=.047) and shifting (β=.24, R2=.06, p=.023). Conclusions: Findings suggest that known EF difficulties in DS are already evident at this young age. Children with DS already have limited cognitive reserve and can ill afford additional EF deficit associated with OSA. OSA is amenable to treatment and should be actively treated in these children to promote optimal cognitive development.

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    JO - Behavioral Sleep Medicine

    JF - Behavioral Sleep Medicine

    SN - 1540-2002

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