Snoring during early childhood and academic performance at ages thirteen to fourteen years
Snoring during early childhood and academic performance at ages thirteen to fourteen years
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DOI：
10.1542/peds.107.6.1394
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发表时间：
2001-06-01
期刊：
影响因子：
8
通讯作者：
Pope, DW
中科院分区：
文献类型：
--
作者：
Gozal, D;Pope, DW
目标。幼儿的阻塞性睡眠呼吸暂停综合征会对学习产生不利影响。然而，儿童早期睡眠呼吸障碍（SDB）对学习的长期影响仍不清楚。方法。调查问卷被邮寄给在公立学校就读的七年级和八年级学生，这些学生的班级排名要么是班级前 25%（高表现 [HP]），要么是后 25%（低表现 [LP]），并且调查问卷的年龄、性别、种族、学校和居住街道都匹配。评估了 2 至 6 岁时的打鼾频率和响度、针对打鼾或反复感染的扁桃体切除术和腺样体切除术 (T&A)、学校成绩以及父母吸烟和打鼾情况。结果。问卷回复率为82.8%。由于持续打鼾，13 名受访者被排除在外，因此可以分析 1588 份问卷（LP 组 797 份，HP 组 791 份）。据报道，103 名 LP 儿童 (12.9%) 在儿童早期经常打鼾，而 40 名 HP 儿童 (5.1%；比值比：2.79；置信区间：1.88-4.15)。此外，24 名 LP 和 7 名 HP 儿童因打鼾接受了 T&A（比值比：3.40；置信区间：1.47-7.84），而 21 名 LP 和 19 名 HP 儿童因复发性扁桃体炎需要手术。结论。与表现较好的同学相比，中学学习成绩较低的孩子在幼儿期更有可能打鼾，并且需要进行打鼾 T&A 治疗。这些发现支持这样的观点，即与 SDB 相关的神经认知发病可能只是部分可逆的，或者在幼儿期可能会因 SDB 而产生“学习债”并妨碍随后的学校表现。
Objectives. Obstructive sleep apnea syndrome in young children is associated with an adverse effect on learning. However, the long-term impact of sleep-disordered breathing (SDB) during early childhood on learning remains unknown.Methods. Questionnaires were mailed to seventh and eighth graders attending public schools whose class ranking was either in the top 25% (high performance [HP]) or bottom 25% of their class (low performance [LP]), and who were matched for age, gender, race, school, and street of residence. Snoring frequency and loudness at 2 to 6 years of age, tonsillectomy and adenoidectomy (T&A) for snoring or recurrent infection, school grades, and parental smoking and snoring were assessed.Results. The questionnaire response rate was 82.8%. Because of ongoing snoring, 13 responders were excluded, such that 1588 questionnaires could be analyzed (797 in LP and 791 in HP group). Frequent and loud snoring during early childhood was reported in 103 LP children (12.9%) compared with 40 HP children (5.1%; odds ratio: 2.79; confidence interval: 1.88-4.15). Furthermore, 24 LP and 7 HP children underwent T&A for snoring (odds ratio: 3.40; confidence interval: 1.47-7.84), while 21 LP and 19 HP children required surgery for recurrent tonsillitis.Conclusions. Children with lower academic performance in middle school are more likely to have snored during early childhood and to require T&A for snoring compared with better performing schoolmates. These findings support the concept that SDB-associated neurocognitive morbidity may be only partially reversible or that a "learning debt" may develop with SDB during early childhood and hamper subsequent school performance.