Sleep Apnea – Children with untreated Severe OSA have Lower IQ

Sleep Apnea – Children with untreated Severe OSA have Lower IQ

Johns Hopkins researchers have showed children’s brains with untreated sleep apnea to damage two parts of the brain that are linked to learning abilities. The study was first published in the online August 22nd edition of the journal, Public Library of Science Medicine.

The researchers used MRI technology to look at the brain activity of 19 children that had severe obstructive sleep apnea (OSA). They also measured the brain activity of 12 children that did not have any problems with breathing while they sleep. The two locations that were measured with the MRI were the hippocampus and the right frontal cortex.

The researchers completed a series of IQ tests that are used as standardized performance tests which measures the child’s verbal performance, memory, and executive function. The children with severe obstructive sleep apnea had an average score of 85 while the children that did not have OSA scored 101. The verbal working memory standardized test showed the children with OSA were 8 compared with those without at 15. Word Fluency standardized test measured 9.7 for the sleep apnea children versus 12 for children without OSA.

The researchers were able to see noticeable difference in the MRI brain activity in the two groups. The hippocampus is important for learning and memory storage. The right frontal cortex is important for complex thinking such as using old situations to solve current problems.

“This should be a wake-up call to both parents and doctors that undiagnosed or untreated sleep apnea might hurt children’s brains,” said lead author Ann Halbower, M.D., a lung specialist at the Johns Hopkins Children’s Center. “This is truly concerning because we saw changes that suggest brain injury in areas of the brain that house critical cognitive functions, such as attention, learning and working memory.”

Obstructive sleep apnea caused breathing to become blocked for short period of time, which leads to oxygen deprivation. If your child snores you should tell your pediatrician. The most common reason for obstructive sleep apnea in children may be from enlarged tonsils and adenoids which could be removed to fix the problem. If the blockage is not caused by the tonsils a child may need to were a mask and using breathing equipment called a CPAP which provides constant air flow to keep the air passages open while they sleep.

“We cannot say with absolute certainty that sleep apnea caused the injury, but what we found is a very strong association between changes in the neurons of the hippocampus and the right frontal cortex and IQ and other cognitive functions in which children with OSA score poorly,” Halbower said.
The researchers want to continue to study how much improvement a child with severe obstructive sleep apnea is possible once there is treatment for the condition. They are not sure if the brain changes and intelligence levels become permanent during development even if they get treatment for the obstructive sleep apnea.

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