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Cited by 446Obstructive Sleep Apnea ResearchSleep and related disordersNeuroscience of respiration and sleep

Neurobehavioral Morbidity Associated With Disordered Breathing During Sleep in Children: A Comprehensive Review

Beebe, Dean W.·2006·Sleep
DOI 10.1093/sleep/29.9.1115
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Abstract

STUDY OBJECTIVES: To comprehensively review research on the association between childhood sleep-disordered breathing (SDB) and neurobehavioral functioning. DESIGN: Qualitative and quantitative literature review. SETTING: N/A. PATIENTS OR PARTICIPANTS: N/A. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: The findings of 61 studies of the relationship between childhood SDB and neurobehavioral functioning were critically evaluated and synthesized. There is strong evidence that childhood SDB is associated with deficits in behavior and emotion regulation, scholastic performance, sustained attention, selective attention, and alertness. There is also evidence that SDB has minimal association with a child's typical mood, expressive language skills, visual perception, and working memory. Findings have been insufficient to draw conclusions about intelligence, memory, and some aspects of executive functioning. Mechanisms by which SDB might result in neurobehavioral morbidity are being explored, but clinical symptoms such as chronic snoring remain the best predictors of morbidity. Short-term SDB treatment outcome studies are encouraging, but the long-term outcomes are not known. Failing to treat SDB appears to leave children at risk for long-term neurobehavioral deficits. CONCLUSIONS: Childhood SDB is associated with neurobehavioral morbidity. Applying commonly used guidelines for causal inference, even in the absence of a much-needed randomized clinical trial, there is strong evidence of association, consistent findings, and specificity of effect. There is suggestive evidence that this association fits the expected temporal pattern and that SDB is a biologically plausible cause of neurobehavioral deficits. Clinicians should be alert to the coexistence of SDB symptoms and concerns about a child's academic progress, attention, arousal, or behavior or emotion regulation.

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Crossref · 10.1093/sleep/29.9.1115

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145 of 145 references verified0 citation errors · 0 not checkable

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  • Sleep-disordered breathing (SDB) has been consistently associated with neurobehavioral and neurocognitive deficits, including inattentive or ADHD-like symptoms.

    “SDB has been consistently associated with neurobehavioral and neurocognitive deficits, including inattentive or ADHD-like symptoms (Beebe 2006; Beebe et al. 2004; Chervin et al. 2002, 2012; Gottlieb et al. 2003; Lal et al. 2012; O’Brien 2009; Owens 2008; Rosen et al. 2004; Soylu et al. 2013; Suratt et al. 2011).”

    From Associations of sleep disturbance with ADHD: implications for treatment (2015) · cites this paper as Beebe 2006

  • The effects of restricted, disordered or disturbed sleep can manifest as symptoms, behaviors or functional impairments that are remarkably similar to those of ADHD.

    “The effects of restricted, disordered or disturbed sleep can manifest as symptoms, behaviors or functional impairments that are remarkably similar to those of ADHD (Beebe 2006; Gruber 2009; O’Brien 2009).”

    From Associations of sleep disturbance with ADHD: implications for treatment (2015) · cites this paper as Beebe 2006

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Authors
Beebe, D. W.
Affiliations
Cincinnati Children's Hospital Medical Center (US)
Corresponding author
Beebe, Dean W.
ORCID
Beebe, Dean W.
Venue
Sleep
Publisher
Oxford University Press (OUP)
Published
2006-09
Volume
29
Issue
9
Pages
1115-1134
ISSN
  • 0161-8105 (ISSN-L)
  • 1550-9109
DOI
10.1093/sleep/29.9.1115
OpenAlex
W2148037653
Cited by
446
References
145
Citations by year
2026: 16 · 2025: 13 · 2024: 13 · 2023: 22 · 2022: 19 · 2021: 34 · 2020: 16 · 2019: 25 · 2018: 20 · 2017: 26 · 2016: 22 · 2015: 27 · 2014: 24 · 2013: 29 · 2012: 31
FWCI
12.59
Type
journal article
Language
en
Open access
closed
Locations
  • SLEEP (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Heart, Lung, and Blood Institute (K23HL075369)
Topics
  • Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Neuroscience of respiration and sleep
Keywords
sleep-disordered breathing, pediatric sleep apnea, academic performance, sustained attention, selective attention, alertness, executive function, working memory, causal inference
MeSH terms
Attention Deficit Disorder with Hyperactivity, Brain, Child, Cognition Disorders, Humans, Disorders of Excessive Somnolence, Memory Disorders, Neuropsychological Tests, Severity of Illness Index, Sleep Apnea Syndromes, Mood Disorders, Sleep Apnea, Obstructive

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