Impact of Childhood Sleep Disordered Breathing

描述（由申请人提供）：越来越多的证据表明儿童睡眠呼吸障碍 (SDB) 与行为障碍以及在学校和神经认知测试中表现较差有关。然而，SDB 的自然历史和长期影响仍有待确定。这项竞争性更新的主要目标是确定在青春期前发现的 SDB 对随后的学校和神经认知表现的影响，评估影响儿童 SDB 自然史的因素，并确定这些因素在白人和西班牙裔之间是否存在差异。另一个目标是评估先前确定的通气驱动变化在后续评估中是否持续存在。因此，该项目建议重新评估图森儿童睡眠呼吸暂停评估 (TuCASA) 队列。这组儿童最初招募的年龄为 6 至 11 岁，旨在分析儿童 SDB 的患病率和相关性，具有良好的特征，是实现以下具体目标的理想工具：1) 确定青春期前儿童的 SDB 是否会对大约 4 年后这些儿童的学校和神经认知表现、生长和血压产生不利影响，并比较白人和西班牙裔之间的研究结果； 2) 计算最初研究的 6 至 11 岁儿童中 SDB 的 4 年发病率、缓解率以及当前患病率，并评估青春期前是否存在影响这些发病率的种族和/或人体测量特征； 3) 评估先前观察到的通气驱动异常是否在几年后仍然存在； 4) 确定是否可以使用工作记忆和持续注意力的新颖测试来检测 4 年前患有 SDB 的儿童执行和额叶功能的细微变化，该测试结合了任务执行过程中获得的脑电图 (EEG) 测量。 TuCASA 队列中的大约 425 名儿童将在无人看管的情况下重复进行家庭多导睡眠图、神经认知测试电池、完成与睡眠相关的调查问卷，并在初次招募后大约 4 年后进行选定的人体测量。此外，在初次 TuCASA 评估期间进行过通气驱动研究的 50 名儿童的子集将重复这些研究。第二项子研究将采用 TuCASA 队列中的 50 对病例对照子集，这些人在 4 年前被发现患有或不患有 SDB，但年龄、性别、种族和智力都匹配。这些孩子将接受持续工作记忆任务，通过同时记录脑电图来评估工作记忆和持续注意力。这些数据将为说明 SDB 对儿童生长发育的长期影响提供重要证据。

DESCRIPTION (provided by applicant): Increasing evidence links sleep disordered breathing (SDB) in children to behavioral disturbances, and to poorer performance in school and on neurocognitive tests. However, the natural history and long-term impact of SDB remains to be determined. The primary objectives of this competitive renewal are to determine the impact of SDB identified in preadolescents on subsequent school and neurocognitive performance, to assess factors, which influence the natural history of SDB in children and to ascertain whether these elements differ between Caucasians and Hispanics. An additional objective is to assess whether previously identified changes in ventilatory drive persist on subsequent evaluation. This project thus proposes a reevaluation of the Tucson Children's Assessment of Sleep Apnea (TuCASA) cohort. This cohort of children initially recruited from ages 6 through 11 years to analyze the prevalence and correlates of childhood SDB, is well characterized, and is an ideal vehicle to achieve the following specific aims: 1) to determine whether SDB in preadolescent children adversely impacts school and neurocognitive performance, growth and blood pressure in these same children approximately 4 years later, and to compare findings between Caucasians and Hispanics; 2) to calculate the 4- year incidence and remission rates and current prevalence of SDB in children who were initially studied from ages 6 through 11 years, and to assess whether there are ethnic and/or anthropometric characteristics in preadolescence that influence these rates; 3) to assess whether abnormalities previously observed in ventilatory drive persist several years later; 4) to determine whether subtle changes in executive and frontal-lobe function can be detected in children who had SDB 4 years previously using a novel test of working memory and sustained attention which incorporates electroencephalographic (EEG) measures obtained during task performance. Approximately 425 children in the TuCASA cohort will undergo a repeat unattended home polysomnogram, neurocognitive test battery, complete questionnaires related to sleep and have selected anthropometric measurements taken approximately 4 years after their initial recruitment. In addition, a subset of 50 children who had ventilatory drive studies during their initial TuCASA evaluation will have these studies repeated. A second sub study will employ a 50 pair case control subset of the TuCASA cohort who were found to have, or not have SDB 4 years previously, but who are matched on age, gender, ethnicity and intelligence. These children will undergo the Sustained Working Memory Task that assesses working memory and sustained attention with concurrent recording of EEG. These data will provide important evidence concerning the long-term impact of SDB on growth and development in children.