Sleep disordered breathing and neurocognitive function in children post-adenotonsillectomy: Three year follow-up

打鼾症非常普遍，影响了至少10%的儿童，也就是澳大利亚估计有25万儿童。它与包括智力、记忆、推理、学习和行为在内的广泛神经认知领域的缺陷有关。我们最近研究了53名打鼾儿，包括摘除扁桃体和腺样体六个月后的打鼾症，以治疗与打鼾症相关的可疑的上呼吸道阻塞。我们发现，在手术前，智力、记忆、推理、语言和行为明显下降，与53名年龄、性别、社会阶层和居住地相匹配的非鼾症对照组儿童相比，下降了10%。令我们大吃一惊的是，在手术后6个月，我们发现尽管睡眠和行为有所改善，但智力、记忆力、推理和语言发展却没有改善。我们现在希望在扁桃体和腺样体切除后3年对这些儿童进行研究，因为我们相信，如果我们在6个月时描述的缺陷仍然存在，它们现在很可能是永久性的。鉴于我们发现与非鼾症儿童相比，鼾症儿童的缺陷程度，即使在鼾症儿童接受治疗6个月后，如果术后3年仍存在这些缺陷，那么这些缺陷很可能会影响孩子未来的学习潜力和学业成就。反过来，这将表明，及早识别和治疗睡眠相关的上呼吸道阻塞对于预防儿童白天功能和行为的长期缺陷至关重要。

Snoring is very common and affects at least 10% of children, or an estimated 0.25 million children in Australia. It is associated with deficits in a wide range of neurocognitive areas including intelligence, memory, reasoning, learning and behaviour. We have recently studied a group of 53 snoring children both before and six months after removal of their tonsils and adenoids, to treat suspected upper airway obstruction associated with their snoring. We found that prior to surgery, intelligence, memory, reasoning, language and behaviour were significantly reduced, by up to 10% compared to 53 non-snoring control children matched by age, gender, social class and area of residence. To our great surprise, at six months after surgery we found that although sleep and behaviour improves, intelligence, memory, reasoning and language development do not. We now wish to study these same children at 3 years after tonsils and adenoids removal, as we believe that if the deficits that we described at 6 months are still present, they are likely now to be permanent. Given the degree of deficit that we have found in snoring compared to non-snoring children, even 6 months after the snoring group of children have been treated, if still present at 3 years post-surgery then it is likely that these deficits will affect the children's future learning potential and academic success. In turn, this would suggest that early identification and treatment of sleep-related upper airway obstruction is critical in preventing long-term deficits in children's daytime functioning and behaviour.