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.