Conclusions
Children with SDB demonstrate broadly average cognitive abilities in
comparison to normative data across global intellectual functioning,
memory, attention, EF, and language
domains.9,14-16,18-21,29 However, these children often
perform significantly worse on measures of cognitive functioning when
compared to controls without SDB.9,14,17,19,28 These
differences were often observed across the SDB spectrum, including
children with PS or mild OSA, indicating that low levels of SDB increase
risk for cognitive difficulties.11,16,28,30 It is
critical to consider contextual variables when interpreting the effects
of SDB on cognition. Factors such as chronic health conditions and
perceived discrimination, which indirectly influence cognition for
African Americans51, were not included in any of the
reviewed studies. Future research should include known predictors of
health disparities when investigating the relationship of SDB on
cognition. Future research should also explore the above findings across
additional cultural contexts.
The underlying mechanisms for cognitive consequences of SDB are still
being investigated. Research supports the role of disrupted sleep
architecture and intermittent hypoxia on chronic inflammation, which is
associated with cognitive deficits. 5,28 There appears
to be an interaction between genetic susceptibility and environmental
factors, which may explain why some children with SDB have cognitive
impairments, while others do not.56-57 Further
research is needed to strengthen our understanding of the mechanisms
that underlie the neurocognitive profiles of children with SDB.
Clinicians, educators, and individuals from the general population must
be educated on SDB and the neurocognitive sequalae of SDB in order to
increase rates of early identification and early care.