Hearing loss mediates executive function impairment in sleep-disordered breathing

Catherine M. Hill, Romola S. Bucks, Colin R. Kennedy, Dawn Harrison, Annette Carroll, Nicolas Upton, Alexandra M. Hogan

Research output: Contribution to journalArticle

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 through 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), Behaviour Rating of Executive Function (BRIEF-P), and Childhood Middle Ear Disease and Hearing questionnaires. Polysomnography in snoring children generated an obstructive apnoea/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 a 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 apnoea (OSA) (OAHI ≥ 5) and 25 without OSA. OSA had a direct effect on SDQ scores, but this was not mediated by a 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.

Original languageEnglish
Pages (from-to)18-23
Number of pages6
JournalSleep Medicine
Volume34
DOIs
Publication statusPublished - 1 Jun 2017

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Executive Function
Sleep Apnea Syndromes
Hearing Loss
Snoring
Obstructive Sleep Apnea
Conductive Hearing Loss
Hearing
Pure-Tone Audiometry
Ear Diseases
Audiometry
Polysomnography
Apnea
Middle Ear
Hypertrophy

Cite this

Hill, C. M., Bucks, R. S., Kennedy, C. R., Harrison, D., Carroll, A., Upton, N., & Hogan, A. M. (2017). Hearing loss mediates executive function impairment in sleep-disordered breathing. Sleep Medicine, 34, 18-23. https://doi.org/10.1016/j.sleep.2017.02.008
Hill, Catherine M. ; Bucks, Romola S. ; Kennedy, Colin R. ; Harrison, Dawn ; Carroll, Annette ; Upton, Nicolas ; Hogan, Alexandra M. / Hearing loss mediates executive function impairment in sleep-disordered breathing. In: Sleep Medicine. 2017 ; Vol. 34. pp. 18-23.
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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 through 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), Behaviour Rating of Executive Function (BRIEF-P), and Childhood Middle Ear Disease and Hearing questionnaires. Polysomnography in snoring children generated an obstructive apnoea/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 a 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 apnoea (OSA) (OAHI ≥ 5) and 25 without OSA. OSA had a direct effect on SDQ scores, but this was not mediated by a 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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Hill, CM, Bucks, RS, Kennedy, CR, Harrison, D, Carroll, A, Upton, N & Hogan, AM 2017, 'Hearing loss mediates executive function impairment in sleep-disordered breathing' Sleep Medicine, vol. 34, pp. 18-23. https://doi.org/10.1016/j.sleep.2017.02.008

Hearing loss mediates executive function impairment in sleep-disordered breathing. / Hill, Catherine M.; Bucks, Romola S.; Kennedy, Colin R.; Harrison, Dawn; Carroll, Annette; Upton, Nicolas; Hogan, Alexandra M.

In: Sleep Medicine, Vol. 34, 01.06.2017, p. 18-23.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Hearing loss mediates executive function impairment in sleep-disordered breathing

AU - Hill, Catherine M.

AU - Bucks, Romola S.

AU - Kennedy, Colin R.

AU - Harrison, Dawn

AU - Carroll, Annette

AU - Upton, Nicolas

AU - Hogan, Alexandra M.

PY - 2017/6/1

Y1 - 2017/6/1

N2 - 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 through 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), Behaviour Rating of Executive Function (BRIEF-P), and Childhood Middle Ear Disease and Hearing questionnaires. Polysomnography in snoring children generated an obstructive apnoea/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 a 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 apnoea (OSA) (OAHI ≥ 5) and 25 without OSA. OSA had a direct effect on SDQ scores, but this was not mediated by a 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.

AB - 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 through 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), Behaviour Rating of Executive Function (BRIEF-P), and Childhood Middle Ear Disease and Hearing questionnaires. Polysomnography in snoring children generated an obstructive apnoea/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 a 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 apnoea (OSA) (OAHI ≥ 5) and 25 without OSA. OSA had a direct effect on SDQ scores, but this was not mediated by a 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.

KW - Conductive hearing loss

KW - Executive function

KW - Obstructive sleep apnoea

KW - Sleep disordered breathing

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