ABSTRACT
As a clinician tracking symptoms of both sleep apnea and attention deficit disorder (ADD), I have found that sleep apnea has the potential to have a severe impact upon the cognitive, emotional, and academic development of children, which increases in a stepwise manner as they age. Risk factors and related problems are further detailed in the chapter by Drs. Huang and Guilleminault. From a neuropsychological perspective, younger children carry greater risks and are more affected on tests of memory and frontal processes. The more severe the undiagnosed or unresolved apnea, the greater the impact upon the developing brain. Rauch describes the normal variants of sleep in her chapter and the significance of specific sleep determinants. Variables of desaturation, apneas occurring in rapid eye movement (REM) sleep, and the length and duration of the apneic event are additional determinants whose impact matches the severity seen on neuropsychological evaluation. The pervasive effects of oxygen deprivation are well known and well documented. When occurring within the first year of life, the impact seen on neuropsychological evaluation is pervasive. These are the children who historically experience difficulty acquiring language and are at risk to develop seizures.
