BACKGROUND Children with congenital heart disease (CHD) have an increased risk of neurocognitive impairment. No prior studies have evaluated the role of obstructive sleep apnea (OSA), which is associated with neurocognitive impairment in children without CHD. RESEARCH QUESTION Is OSA is associated with neurocognitive impairment in children with CHD? STUDY DESIGN AND METHODS Children age 6-17 years with corrected moderate-complex CHD without syndromes that may affect neurocognition were recruited from the pediatric cardiology clinic. Participants underwent home sleep testing and neurocognitive testing including a validated IQ test as well as validated tests of memory (Paired Associates Learning test), executive function (Intra-Extra Dimensional set shift test) and attention (Simple Reaction Test) from the CANTAB neurocognitive testing battery. RESULTS Complete results were available for 30 children. Seventeen children (57%) were found to have OSA. Total IQ was markedly lower in children with CHD and comorbid OSA compared to children with CHD without comorbid OSA (mean 86 ± 12, vs 98 ± 11, p=0.01). Children with CHD and OSA did significantly worse on the Paired Associates Learning test, with a median of 8 total errors (interquartile range [IQR] 2.25-15) compared to children with CHD without OSA (median total errors 2, IQR 1-8), p=0.02. INTERPRETATION Children with CHD and comorbid OSA have impaired neurocognition compared to children with CHD without comorbid OSA. OSA may be a reversible cause of neurocognitive impairment in children with CHD. Further research is needed to evaluate the effects of OSA treatment on neurocognitive impairment in children with CHD.

中文翻译：

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先天性心脏病患儿的阻塞性睡眠呼吸暂停和神经认知障碍

背景 患有先天性心脏病 (CHD) 的儿童患神经认知障碍的风险增加。之前没有研究评估阻塞性睡眠呼吸暂停 (OSA) 的作用，OSA 与非 CHD 儿童的神经认知障碍有关。研究问题 OSA 是否与 CHD 儿童的神经认知障碍有关？研究设计和方法 从儿科心脏病诊所招募了年龄在 6-17 岁且没有可能影响神经认知的综合征的矫正中度复杂 CHD 儿童。参与者接受了家庭睡眠测试和神经认知测试，包括经过验证的 IQ 测试以及来自 CANTAB 神经认知测试的经过验证的记忆测试（配对伙伴学习测试）、执行功能（内超维集合转换测试）和注意力（简单反应测试）电池。结果 30 名儿童可获得完整的结果。发现 17 名儿童 (57%) 患有 OSA。与没有合并 OSA 的 CHD 儿童相比，合并有合并 OSA 的 CHD 儿童的总 IQ 显着降低（平均 86 ± 12，对比 98 ± 11，p=0.01）。与没有 OSA 的 CHD 儿童相比，患有 CHD 和 OSA 的儿童在 Paired Associates Learning 测试中的表现明显更差，总错误中位数为 8（四分位距 [IQR] 2.25-15）（总错误中位数为 2，IQR 1-8） , p=0.02。解释 与没有合并 OSA 的 CHD 儿童相比，合并有合并 OSA 的 CHD 儿童的神经认知功能受损。OSA 可能是 CHD 儿童神经认知障碍的可逆原因。需要进一步研究来评估 OSA 治疗对 CHD 儿童神经认知障碍的影响。