Sleep and neuropsychological functioning in school aged children

Abstract

This thesis investigated the relationship between sleep disturbance and neuropsychological functioning in healthy, typically developing children and children with cystic fibrosis (CF). Three research questions were examined in this thesis. The first examined whether sleep disturbance is associated with specific deficits in executive functions or an overall deficit in executive functioning. The second research question examined the relationship between sleep disturbance and behaviour problems. A final research question examined whether sleep disturbance, in the absence of hypoxia, affects executive functioning in a comparable way to sleep disturbance associated with hypoxia.
The first study demonstrated that global executive function (GEF) was significantly lower in healthy children with higher sleep disturbance. Sleep disturbance was not associated with individual performance on executive function tasks.
The second study also examined sleep and executive function in healthy children using a revised battery of neuropsychological tests. Compared to children with low sleep disturbance, children with high sleep disturbance had significantly lower GEF and lower processing speed. Both sleep quantity and sleep quality predicted GEF however sleep quantity explained an additional unique proportion of the variance.
The third study examined sleep in children with cystic fibrosis. When dichotomized into high and low sleep disturbed groups, neither GEF nor processing speed was significantly different between the two groups. The sleep and neuropsychological functioning of children with CF was compared to the healthy, typically developing children from Study 3. There were no significant differences between children with CF and healthy controls on any sleep measures or executive function performance. Nine children with CF underwent one night of polysomnography. A further aim of Study 3 was to examine whether neuropsychological deficits were greater if in the presence of both high sleep disturbance and nocturnal hypoxia. Executive function deficits were worse in children with nocturnal hypoxia, irrespective of whether they had high or low sleep disturbance. In contrast, processing speed deficits were more evident in children with high sleep disturbance, irrespective of whether they had nocturnal hypoxia.
A consistent finding throughout this thesis was that children with higher conduct problems have increased sleep disturbance (measured using parent report and actigraphy).
These findings have implications for children’s development; future research examining the effects of sleep disturbance on executive function should consider whether these effects are irreversible.

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