Sleep Apnea Hurts Kids’ Brain Function

Treatment for kids’ sleep apnea shown to improve attention span.

Obstructive sleep apnea in children produces chemical changes in brain areas associated with learning, memory, and executive function, a researcher said here.

Luckily, treatment for the sleep apnea appears to reverse many of those brain changes, Ann Halbower, MD, of Children’s Hospital Sleep Center in Denver, said here at the annual meeting of the American Thoracic Society.

A small study found that the normalization of the brain chemistry resulting from treatment was associated with a corresponding improvement in attention and executive function, Halbower told reporters after her oral presentation.

In the study, Halbower and colleagues tested 16 children with obstructive sleep apnea and 11 healthy controls for brain metabolites using magnetic resonance spectroscopy. The participants also were given a battery of neuropsychological tests, Halbower said.

At the same time, the patients had significant decreases in working memory, attention, and verbal memory compared with controls, Halbower said.

Treatment was usually with adenotonsillectomy, she said, although some children also required the use of a continuous positive airway pressure (CPAP) machine.

Six months after treatment, some of the brain deficits were reversed, Halbower said.

On average, hippocampal metabolites also rose but did not return completely to normal, she said, speculating that the hippocampus may simply take longer to recover. On the other hand, among children with milder disease, recovery was complete in both regions, Halbower said.

In addition, she reported, attention and executive function in the treated children rose significantly from baseline and was no longer different from the healthy controls 6 months after treatment.

“Earlier diagnosis and treatment may improve the trajectory of development,” she said.

The study raises the question of what’s causing the problems – low oxygen levels or the frequent arousals needed to overcome low oxygen, commented Mary Morrell, PhD, of Imperial College London, who was not a part of the study but who moderated a press conference at which details were presented.

“We always need to try to dissect that out so that we can target therapy appropriately,” Morrell said.

“The metabolites are an index of how active the brain is,” she added, “and one thought is that if you have sleep apnea long enough, the neurons actually die.”

Both in children and adults, “the more we study these patients, the more we think the sleep apnea is damaging the brain,” she said.

By Michael Smith