Frequency of snoring, rather than the apnea–hypopnea index, predicts cognitive and behavioural problems in young children

Smith, Gozal, Hunter & Kheirandish-Gozal (2017)

Objective: Primary snoring (PS) and obstructive sleep apnoea (OSA) not only affect sleep quality in a large proportion of young children but have also been repeatedly linked to a range of behavioural and cognitive difficulties. However, little is known about the potentially distinct relationships between behavioural and cognitive pathology across the spectrum of sleep-disordered breathing (SDB).

Method: This study examined data from a community sample enriched for snoring, comprising 631 children aged between 4 and 10 years. Multivariate mixed models were used to assess the relationship between snoring frequency and the apnea–hypopnea index (AHI). A variety of cognitive and behavioural variables were analysed while adjusting for several key demographic factors. These were followed by univariate analyses of individual measures and sensitivity analyses.

Results: The findings indicated that snoring status was a significant predictor of overall behavioural (p = 0.008) and cognitive (p = 0.013) domains, even after adjusting for baseline covariates and AHI severity. Higher snoring frequency was associated with poorer outcomes regardless of AHI. However, AHI did not emerge as a significant predictor of overall cognitive functioning (p = 0.377). Furthermore, although AHI was a significant predictor of overall behavioural functioning (p = 0.008), the pattern of significance and the nature of its relationship with individual behavioural measures were inconsistent in post-hoc analyses.

Conclusion: These findings suggest that general cognitive and behavioural functioning may decline with increased snoring severity.

Download the article at: Frequency of snoring, rather than apnea–hypopnea index, predicts both cognitive and behavioural problems in young children (https://pubmed.ncbi.nlm.nih.gov/28522088/)