Journal of the International Neuropsychological Society


Neuropsychological effects of pediatric obstructive sleep apnea

DEAN W.  BEEBE  a1 a2 c1 , CAROLYN T.  WELLS  a1 a3 , JENNIFER  JEFFRIES  a1 , BARBARA  CHINI  a1 a2 , MANINDER  KALRA  a1 a2 and and RAOUF  AMIN  a1 a2
a1 Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
a2 University of Cincinnati College of Medicine, Cincinnati, Ohio
a3 University of Cincinnati College of Arts and Sciences, Cincinnati, Ohio

Article author query
beebe dw   [PubMed][Google Scholar] 
wells ct   [PubMed][Google Scholar] 
jeffries j   [PubMed][Google Scholar] 
chini b   [PubMed][Google Scholar] 
kalra m   [PubMed][Google Scholar] 
amin r   [PubMed][Google Scholar] 


Obstructive sleep apnea (OSA) is a fairly common nocturnal breathing disorder, affecting 2–4% of individuals. Although OSA is associated with medical morbidity, its most functionally disruptive effects in adults appear to be neuropsychological in nature. Research on the neuropsychological effects of pediatric OSA has been limited. This study compared the neuropsychological functioning of school-aged children with OSA to that of healthy children. The primary goal was to clarify the presence and pattern of neuropsychological morbidity associated with pediatric OSA. Sleep was assessed with parent-report questionnaires and laboratory sleep studies. Neuropsychological functioning was assessed by formal tests and parent- and teacher-report questionnaires. Data indicated OSA-related cognitive and behavioral impairment that was particularly marked on measures of behavior regulation and some aspects of attention and executive functioning. Minimal effects were observed on measures of intelligence, verbal memory, or processing speed. Exploratory analyses failed to indicate any clear relationship between neuropsychological functioning and objective indexes of hypoxia or sleep disruption, though the sample was small. These data add to a growing literature which suggests that significant neuropsychological deficits are associated with pediatric OSA. Findings suggest a pattern of neuropsychological morbidity that is similar but not identical to that seen in adult OSA. (JINS, 2004, 10, 962–975.)

(Received January 15 2004)
(Accepted June 7 2004)

Key Words: Children; Sleep disorders; Hypoxia; Sleep disturbance; Executive functioning.

c1 Reprint requests to: Dean Beebe, Ph.D., Psychology Division (MLC 3015), Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229-3039. E-mail: