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Hearing loss mediates executive function impairment in sleep disordered breathing

Hearing loss mediates executive function impairment in sleep disordered breathing
Hearing loss mediates executive function impairment in sleep disordered breathing

Background: Sleep disordered breathing (SDB) is often co-morbid with conductive hearing loss in early childhood, due to a shared aetiology of adenotonsillar hypertrophy. Hearing loss is independently associated with impairment of executive function and behavioural difficulties. We hypothesised that these impairments in children with SDB may be mediated via hearing loss.

Methods: Fifty-eight children including 37 snorers awaiting adenotonsillectomy and 21 healthy non-snoring controls, aged 3-5 years, were assessed with pure tone audiometry, Strengths and Difficulties (SDQ), Behavior Rating of Executive Function (BRIEF-P) and Childhood Middle Ear Disease and Hearing questionnaires. Polysomnography in snoring children generated an obstructive apnea/hypopnea index (OAHI). Two regression models examined the effect of SDB and the mediating impact of hearing loss on BRIEF and SDQ.

Results: Snoring children had significantly poorer hearing, greater past exposure to hearing loss and higher total SDQ and BRIEF-P scores than non-snoring controls. The first regression model, including all children, demonstrated that the impact of snoring on BRIEF_P, but not SDQ, was entirely mediated by history of hearing loss exposure, but not same day audiometry. The second model examined snoring children only, categorising the group into 12 with obstructive sleep apnea (OSA) (OAHI > 5) and 25 without. OSA had a direct effect on SDQ scores but this was not mediated by history of hearing loss.

Conclusion: In early childhood, conductive hearing loss mediates the relationship between SDB, irrespective of severity, and parent report of executive function but not behaviour. Treatment of hearing loss in pre-school SDB might improve executive function.

1389-9457
Hill, Catherine
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Bucks, Romola S.
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Kennedy, Colin
7c3aff62-0a86-4b44-b7d7-4bc01f23ec93
Harrison, Dawn
8cb95f3b-08b3-4511-a836-b07935566795
Carroll, Annette
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Upton, Nicolas
7d484d6b-54a8-4b16-ad72-312e721b40fd
Hogan, Alexandra
7e7820da-6e26-49f0-96ce-06638f88dc87
Hill, Catherine
867cd0a0-dabc-4152-b4bf-8e9fbc0edf8d
Bucks, Romola S.
95c31da3-2a01-45e7-a648-76d84a49edc4
Kennedy, Colin
7c3aff62-0a86-4b44-b7d7-4bc01f23ec93
Harrison, Dawn
8cb95f3b-08b3-4511-a836-b07935566795
Carroll, Annette
5e9925c5-7c8c-400f-a426-1576879bfd9e
Upton, Nicolas
7d484d6b-54a8-4b16-ad72-312e721b40fd
Hogan, Alexandra
7e7820da-6e26-49f0-96ce-06638f88dc87

Hill, Catherine, Bucks, Romola S., Kennedy, Colin, Harrison, Dawn, Carroll, Annette, Upton, Nicolas and Hogan, Alexandra (2017) Hearing loss mediates executive function impairment in sleep disordered breathing. Sleep Medicine. (In Press)

Record type: Article

Abstract

Background: Sleep disordered breathing (SDB) is often co-morbid with conductive hearing loss in early childhood, due to a shared aetiology of adenotonsillar hypertrophy. Hearing loss is independently associated with impairment of executive function and behavioural difficulties. We hypothesised that these impairments in children with SDB may be mediated via hearing loss.

Methods: Fifty-eight children including 37 snorers awaiting adenotonsillectomy and 21 healthy non-snoring controls, aged 3-5 years, were assessed with pure tone audiometry, Strengths and Difficulties (SDQ), Behavior Rating of Executive Function (BRIEF-P) and Childhood Middle Ear Disease and Hearing questionnaires. Polysomnography in snoring children generated an obstructive apnea/hypopnea index (OAHI). Two regression models examined the effect of SDB and the mediating impact of hearing loss on BRIEF and SDQ.

Results: Snoring children had significantly poorer hearing, greater past exposure to hearing loss and higher total SDQ and BRIEF-P scores than non-snoring controls. The first regression model, including all children, demonstrated that the impact of snoring on BRIEF_P, but not SDQ, was entirely mediated by history of hearing loss exposure, but not same day audiometry. The second model examined snoring children only, categorising the group into 12 with obstructive sleep apnea (OSA) (OAHI > 5) and 25 without. OSA had a direct effect on SDQ scores but this was not mediated by history of hearing loss.

Conclusion: In early childhood, conductive hearing loss mediates the relationship between SDB, irrespective of severity, and parent report of executive function but not behaviour. Treatment of hearing loss in pre-school SDB might improve executive function.

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More information

Accepted/In Press date: 23 February 2017
Organisations: Clinical & Experimental Sciences

Identifiers

Local EPrints ID: 406377
URI: https://eprints.soton.ac.uk/id/eprint/406377
ISSN: 1389-9457
PURE UUID: ad2a8c73-3a49-4f46-8496-83692d50dbc2
ORCID for Catherine Hill: ORCID iD orcid.org/0000-0003-2372-5904

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Date deposited: 10 Mar 2017 10:46
Last modified: 27 May 2019 00:36

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