Children with congenital heart disease (CHD) have an increased risk of neurocognitive impairment. No prior studies have evaluated the role of OSA, which is associated with neurocognitive impairment in children without CHD.
Research Question
Is OSA is associated with neurocognitive impairment in children with CHD?
Study Design and Methods
Children aged 6 to 17 years with corrected moderate to complex CHD without syndromes that may affect neurocognition were recruited from the pediatric cardiology clinic. Participants underwent home sleep testing and neurocognitive testing, including a validated Intellectual Quotient (IQ) test as well as validated tests of memory (Paired Associates Learning test), executive function (Intra-Extra Dimensional set shift test), and attention (Simple Reaction Test) from the CANTAB neurocognitive testing battery.
Results
Complete results were available for 30 children. Seventeen children (57%) were found to have OSA. Total IQ was markedly lower in children with CHD and comorbid OSA compared with children with CHD without comorbid OSA (mean, 86 ± 12 vs 98 ± 11; P = .01). Children with CHD and OSA did significantly worse on the Paired Associates Learning test, with a median of eight total errors (interquartile range [IQR], 2.25-15) compared with children with CHD without OSA (median total errors, 2, IQR, 1-8; P = .02).
Interpretation
Children with CHD and comorbid OSA have impaired neurocognition compared with children with CHD without comorbid OSA. OSA may be a reversible cause of neurocognitive impairment in children with CHD. Further research is needed to evaluate the effects of OSA treatment on neurocognitive impairment in children with CHD.
Key Words
cognitive function
congenital heart
OSA
pediatric cardiology
Abbreviations
ADHD
attention-deficit hyperactivity disorder
AHI
apnea-hypopnea index
BRIEF
Behavior Rating Inventory of Executive Function
CHD
congenital heart disease
IQ
Intellectual Quotient
IQR
interquartile range
NIH
National Institutes of Health
TuCASA
Tucson Children’s Assessment of Sleep Apnea
Cited by (0)
FUNDING/SUPPORT: Funding for this project was provided by an American Academy of Sleep Medicine Foundation Jr Faculty award, American Heart Association Career Development Award (19CDA34740005), National Institutes of Health (R61HL151254), and a University of Arizona Health Sciences Career Development Award to Dr Combs.