Original ArticleWorking memory impairment and its associated sleep-related respiratory parameters in children with obstructive sleep apnea

- OSA children had poorer verbal working memory (WM), compared to controls.
- No significant group differences were found in the visuo-spatial domain.
- OSA impacted verbal working memory above and beyond basic attentional impairment.
- Obstructive apnea hypopnea index predicted basic storage deficits in verbal WM.
- Oxygen saturation nadir predicted executive deficits of verbal WM.

Study ObjectiveWorking memory deficits in children with obstructive sleep apnea (OSA) have been reported in previous studies, but the results were inconclusive. This study tried to address this issue by delineating working memory functions into executive processes and storage/maintenance components based on Baddeley's working memory model.MethodsWorking memory and basic attention tasks were administered on 23 OSA children aged 8-12 years and 22 age-, education-, and general cognitive functioning-matched controls. Data on overnight polysomnographic sleep study and working memory functions were compared between the two groups. Associations between respiratory-related parameters and cognitive performance were explored in the OSA group.ResultsCompared with controls, children with OSA had poorer performance on both tasks of basic storage and central executive components in the verbal domain of working memory, above and beyond basic attention and processing speed impairments; such differences were not significant in the visuo-spatial domain. Moreover, correlational analyses and hierarchical regression analyses further suggested that obstructive apnea-hypopnea index (OAHI) and oxygen saturation (SpO2) nadir were associated with verbal working memory performance, highlighting the potential pathophysiological mechanisms of OSA-induced cognitive deficits.ConclusionsVerbal working memory impairments associated with OSA may compromise children's learning potentials and neurocognitive development. Early identification of OSA and assessment of the associated neurocognitive deficits are of paramount importance. Reversibility of cognitive deficits after treatment would be a critical outcome indicator.