Neurocognitive and behavioral morbidity in children with sleep disorders

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Abstract
This review examines in detail progress made regarding our understanding of the presence and pathophysiology of cognitive and behavioral morbidities among children with sleep disorders in general. Particular focus is given to pediatric obstructive sleep apnea. In recent years, increased awareness of the morbid consequences of respiratory sleep disturbances in children has emerged. Evidence suggesting a causal association of intermittent hypoxia and sleep fragmentation with alterations in memory, attention, and intelligence has accumulated. Research has also identified a link between sleep disorders, and problematic and hyperactive behaviors and mood disturbances. Furthermore, there is considerable inter-individual variability in the presence and magnitude of neurobehavioral morbidity at any given level of disease severity. This further suggests that, in addition to the disease per se, both genetic (individual susceptibility) and environmental modifiers play a role in determining morbidity. A more individually tailored approach to detecting morbidity associated with sleep disorders in children, employing biomarkers and gene-related single nucleotide polymorphisms, may ultimately be required to allow more rational prioritization of treatment.