Journal of the International Neuropsychological Society



Learning in children and sleep disordered breathing: Findings of the Tucson Children's Assessment of Sleep Apnea (TuCASA) Prospective Cohort Study


KRIS L.  KAEMINGK  a1 a2 c1 , ALICE E.  PASVOGEL  a1 , JAMES L.  GOODWIN  a3 , SHELAGH A.  MULVANEY  a4 , FERNANDA  MARTINEZ  a3 , PAUL L.  ENRIGHT  a5 , GERALD M.  ROSEN  a6 , WAYNE J.  MORGAN  a1 a3 , RALPH F.  FREGOSI  a7 and STUART F.  QUAN  a3 a5 a8
a1 Department of Pediatrics, University of Arizona Health Sciences Center, Tucson, Arizona
a2 Steele Memorial Children's Research Center, University of Arizona, Tucson, Arizona
a3 Arizona Respiratory Center, University of Arizona, Tucson, Arizona
a4 Department of Psychology, University of Arizona, Tucson, Arizona
a5 Department of Medicine, University of Arizona Health Sciences Center, Tucson, Arizona
a6 Department of Pediatrics, University of Minnesota School of Medicine, Minneapolis, Minnesota
a7 Department of Physiology, University of Arizona, Tucson, Arizona
a8 Sleep Disorders Center, University of Arizona, Tucson, Arizona

Article author query
kaemingk kl   [PubMed][Google Scholar] 
pasvogel ae   [PubMed][Google Scholar] 
goodwin jl   [PubMed][Google Scholar] 
mulvaney sa   [PubMed][Google Scholar] 
martinez f   [PubMed][Google Scholar] 
enright pl   [PubMed][Google Scholar] 
rosen gm   [PubMed][Google Scholar] 
morgan wj   [PubMed][Google Scholar] 
fregosi rf   [PubMed][Google Scholar] 
quan sf   [PubMed][Google Scholar] 

Abstract

We examined the relationship between nocturnal respiratory disturbance and learning and compared learning in children with and without nocturnal respiratory disturbance. Subjects were 149 participants in a prospective cohort study examining sleep in children ages 6–12: The Tucson Children's Assessment of Sleep Apnea study (TuCASA). Sleep was assessed via home polysomnography. Intelligence, learning and memory, and academic achievement were assessed. Parents rated attention. Group comparisons were used to test the hypothesis that the group with an apnea/hypopnea index (AHI) of 5 or more (n = 77) would have weaker performance than the group with AHI less than 5 (n = 72). The group with AHI of 5 or more had weaker learning and memory though differences between groups decreased when arousals were taken into account. There was a greater percentage of Stage 1 sleep in the AHI 5 or more group, and Stage 1 percentage was negatively related to learning and memory in the sample (n = 149). There were negative relationships between AHI and immediate recall, Full Scale IQ, Performance IQ, and math achievement. Hypoxemia was associated with lower Performance IQ. Thus, findings suggest that nocturnal respiratory disturbance is associated with decreased learning in otherwise healthy children, that sleep fragmentation adversely impacts learning and memory, and that hypoxemia adversely influences nonverbal skills. (JINS, 2003, 9, 1016–1026.)

(Received March 5 2002)
(Revised January 22 2003)
(Accepted February 4 2003)


Key Words: Learning; Memory; Sleep disordered breathing; Apnea; Children.

Correspondence:
c1 Reprint requests to: Kris L. Kaemingk, Ph.D., Department of Pediatrics, University of Arizona Health Sciences Center, 1501 N. Campbell, Room 3402, Tucson, AZ 85724. E-mail: kaemingk@peds.arizona.edu