The Relationship Between Sleep and Cognition in Children Referred for Neuropsychological Evaluation: A Latent Modeling Approach

High Prevalence of Obstructive Sleep-Disordered Breathing in Pediatric Patients With Turner Syndrome

OBJECTIVE

Girls with Turner syndrome (TS) often have features that have been associated with obstructive sleep-disordered breathing (oSDB). However, little is known about oSDB in TS. Herein, we aimed to characterize oSDB in young patients with TS and identify associated risk factors.

STUDY DESIGN

Retrospective cross-sectional study.

SETTING

Tertiary care pediatric hospital.

METHODS

We reviewed medical records for patients diagnosed with TS seen at our institution between October 1, 2007 and December 31, 2019 with the first outpatient visit before age 6 years. The prevalence of oSDB was compared to the general pediatric population with 1-sample binomial proportion tests. Clinical characteristics were compared between those diagnosed with oSDB and those without oSDB, and risk factors for oSDB were identified.

RESULTS

Of 151 patients with TS, 73 (48%) were diagnosed with oSDB which is 4-fold higher than the general pediatric population (12%, P < 0.0001). In the multivariable model, adenoid, tonsillar, and inferior turbinate hypertrophy, birthweight, failure to thrive, and older age at the last clinic visit were all associated with increased odds for oSDB.

CONCLUSION

Young children with TS have a high prevalence of oSDB and thus should be screened for oSDB. Polysomnography should be performed in those with associated risk factors and symptoms oSDB. Treatment of oSDB is imperative as individuals with TS are already at increased risk of behavioral problems, neurocognitive deficits, and growth impairment that may be worsened with oSDB.

Mind and skin: Exploring the links between inflammation, sleep disturbance and neurocognitive function in patients with atopic dermatitis

Atopic dermatitis (AD) is a chronic, pruritic and inflammatory, dry skin condition with many known comorbidities. These include airway disease, food allergies, atopic eye disease and autoimmune conditions. Furthermore, there is often significant sleep disturbance as well as increased psychological distress and mental health problems. Severe AD therefore often has a significant impact on the quality of life of both patients and their families. In this review we discuss recent findings on the putative links between AD, its association with itch, sleep disturbance and neuropsychiatric morbidity, including the role of inflammation in these conditions. Itch was thought to predominantly drive sleep disruption in AD. We now understand changes in sleep influence immune cell distribution and the associated inflammatory cytokines, which suggests a bidirectional relationship between AD and sleep. We also increasingly recognize inflammation as a key driver in psychological symptoms and disorders. The link between cutaneous, systemic and possible brain inflammation could at least in part be driven by the sleep deprivation and itch-driven neuronal proliferation seen in AD.

Sleep Quality in the Indian Adult Population During the COVID-19 Pandemic

Background: In response to the COVID-19 pandemic, social distancing measures such as stay-at-home orders were implemented for all non-essential workers. The consequent disruption in the defined daily work routine has impacted both the quality and duration of sleep. Our aim was to evaluate the quality of sleep in the Indian adult population during the COVID-19 pandemic.

Methods: The data were collected between April 17, 2020 and May 24, 2020, and participants were invited openly through social media platforms (Facebook, Twitter, WhatsApp, Instagram). Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI) Questionnaire.

Results: The study population consisted of 808 participants (mean age 30.85 years, 56.7% female). The mean sleep score of the study population was 6.78 ± 3.19 on the PSQI, with a majority (57.2%) of respondents showing 'poor' sleep quality (>5 on PSQI). The mean sleep duration of the study population was found to be 6.9 ± 1.4 h, and sleep latency was 42.64 ± 51.6 min. The PSQI scores were comparable for age, gender, and work status and were not significant. However, a significant association between self-reported mental health and quality of sleep was found (p<0.05). Participants who reported a deterioration in mental health were more likely to have poor sleep quality than those who reported an improvement in their mental health.

Conclusions: The results of this study show that poor sleep quality is widely prevalent among the the general population in India during the COVID-19 pandemic.

Sleepiness, Neuropsychological Skills, and Scholastic Learning in Children

Excessive daytime sleepiness is a frequent condition among children and adolescents that may lead to several and significant daytime consequences, including impaired neurocognitive skills and scholastic performance. Here, we evaluated in one hundred and ninety-one unselected primary school children, the relationship between sleepiness and a wide range of cognitive and academic skills through a standardized neuropsychological test battery. In order to assess the statistical relationship, we performed a partial least squares path modelling, a non-parametrical approach which combined a model of paths between latent variables and the coefficients between indicators and dimensions. Results were validated through the bootstrap approach and suggest that sleepiness is not associated with all cognitive and scholastic abilities, but only with those relying on verbal abilities and complex cognitive functions (i.e., reading comprehension, oral/syntactic comprehension, spelling, and mathematic skills). Our data suggest the idea that sleepiness in children is associated mostly with “higher” (mainly verbal) cognitive function(s), while the visuospatial domain was not affected.