Associations of actigraphy measures of sleep duration and continuity with executive function, vigilance, and fine motor control in children with snoring and mild sleep-disordered breathing.

2023

04/2023

1550-9397

STUDY OBJECTIVES: Children with snoring and mild sleep-disordered breathing may be at increased risk for neurocognitive deficits despite few obstructive events. We hypothesized that actigraphy-based sleep duration and continuity associate with neurobehavioral functioning and explored whether these associations vary by demographic and socioeconomic factors.

METHODS: 298 children enrolled in the Pediatric Adenotonsillectomy Trial, aged 3 to 12 years, 47.3% from racial or ethnic minority groups, with habitual snoring and an apnea-hypopnea index <3 were studied with actigraphy (mean 7.5 ± 1.4 days) and completed a computerized vigilance test (Go-No-Go) and a test of fine motor control (9-Hole Pegboard). Caregivers completed the Behavior Rating Inventory of Executive Function (BRIEF). Regression analyses evaluated associations between sleep exposures (24-hour and nocturnal sleep duration, sleep fragmentation index, sleep efficiency) with the BRIEF Global Executive Composite index, pegboard completion time (fine motor control), and vigilance (d prime on the Go-No-Go), adjusting for demographic factors and study design measures.

RESULTS: Longer sleep duration, higher sleep efficiency and lower sleep fragmentation were associated with better executive function; each additional hour of sleep over 24 hours associated with more than a 3-point improvement in executive function (p=0.002). Longer nocturnal sleep (p=0.02) and less sleep fragmentation (p=0.001) were associated with better fine motor control. Stronger associations were observed for boys and children less than six years old.

CONCLUSIONS: Sleep quantity and continuity are associated with neurocognitive functioning in children with mild sleep-disordered breathing, supporting efforts to target these sleep health parameters as part of interventions for reducing neurobehavioral morbidity.

CLINICAL TRIAL: Pediatric Adenotonsillectomy for Snoring (PATS), clinicaltrials.gov.: NCT02562040.

10.5664/jcsm.10620

J Clin Sleep Med

37185231

Depression and neurocognitive dysfunction in pediatric and young adult chronic kidney disease.

2019

1575-1582

2019 09

1432-198X

<p><strong>BACKGROUND: </strong>Depression affects 7-35% of children with chronic kidney disease (CKD), and in adults with CKD, the presence of depression links to poorer medical outcomes, social functioning difficulties, and neurocognitive impairments. The relationship between depression and neurocognitive function in youth with CKD is unclear. We sought to identify factors associated with depression in youth with CKD and to determine whether depression affects neurocognitive performance.</p>

<p><strong>METHODS: </strong>We conducted cross-sectional analyses in 71 CKD and 64 control participants aged 8 to 25&nbsp;years who completed depression inventories and neurocognitive assessments as part of the Neurocognitive Assessment and Magnetic Resonance Imaging Analysis of Children and Young Adults with CKD Study. In the CKD group, multivariable logistic regression analysis determined associations between clinical and demographic factors and depression. In the full study cohort, multivariable linear regression analyses, including an interaction term between CKD status and depression evaluated the effect of depression on 11 neurocognitive outcome domains.</p>

<p><strong>RESULTS: </strong>Obesity significantly associated with depression in the CKD group (OR 10.25, P = 0.01). In adjusted analyses, depressed youth with CKD scored worse than non-depressed CKD participants by 0.6-1.0 standard deviations in 5 neurocognitive domains: attention, visual memory, visual-spatial, visual working memory, and problem solving.</p>

<p><strong>CONCLUSIONS: </strong>CKD youth with obesity are more likely to be depressed, and those who are depressed exhibit worse neurocognitive performance. Depression may represent a therapeutic target to improve neurocognitive performance in youth with CKD.</p>

10.1007/s00467-019-04265-z

Pediatr. Nephrol.

31049719