Impact of Childhood Sleep Disordered Breathing

描述（由申请人提供）：越来越多的证据将儿童睡眠呼吸障碍（SDB）与行为障碍，以及在学校和神经认知测试中表现较差联系起来。然而，深发展的自然历史和长期影响仍有待确定。这种竞争性更新的主要目标是确定SDB在青春期前确定对随后的学校和神经认知性能的影响，评估因素，影响SDB在儿童的自然历史，并确定这些因素是否不同的高加索人和西班牙裔。另一个目的是评估先前确定的驱力变化是否在后续评价中持续存在。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。该队列最初招募了6至11岁的儿童，以分析儿童SDB的患病率和相关因素，具有良好的特征，是实现以下特定目标的理想工具：1）确定青春期前儿童的SDB是否对这些儿童约4年后的学校和神经认知表现，生长和血压产生不利影响，2）计算6 ~ 11岁儿童SDB的4年发病率、缓解率和当前患病率，并评估青春期前是否存在影响这些发病率的种族和/或人体测量学特征; 3）评估先前观察到的异常在几年后是否持续存在; 4）确定是否可以使用一种新的工作记忆和持续注意力测试来检测4年前患有SDB的儿童的执行和额叶功能的细微变化，该测试包括在任务执行过程中获得的脑电图（EEG）测量。TuCASA队列中约425名儿童将接受重复的无人值守家庭多导睡眠图、神经认知测试组合、完成与睡眠相关的问卷调查，并在首次招募后约4年进行选定的人体测量。此外，在最初的TuCASA评估期间进行了解释性驱动研究的50名儿童的子集将重复这些研究。第二子研究将采用TuCASA队列的50对病例对照子集，这些人在4年前被发现患有或未患有SDB，但在年龄、性别、种族和智力方面匹配。这些儿童将接受持续工作记忆任务，评估工作记忆和持续注意力，同时记录EEG。这些数据将为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.