Attention, discrimination and velocity of learning process in OSA children, before and after adenotonsillectomy

Introduction: Obstructive Sleep Apnea Syndrome (OSAS) in children is associated to Learning Disorders (LD). Objective: To evaluate neurocognition in children with OSAS before and after adenotonsillectomy. Methods: 42 OSAS children of both genders( 28 boys), aged 6 to 13 years (mean age of 8.5 years), with indication for adenotonsillectomy, were evaluated before and 6 months after surgery. The psychological learning test Wechsler Intelligence Scale for Children III was used to assess velocity, discrimination and attention, with symbols, codes and digits. Children were divided into two groups, G1 aged 6 to 7 years, G2 aged 8 to13 years. Children with hearing loss, neurological disease or genetic syndrome were excluded. The results were stratified for age, considering a score of 10 points as normal, ≤ 8 as suspicious, ≤ 7 as LD. Results were correlated with age, gender, apnea and hypopnea index (AHI) and oxygen desaturation index (ODI). Results: Twelve children were diagnosed with LD, 58.4% with disorders in two or more subfields. Eight were considered suspicious. AHI ranged from 4 to 65 n/h, ODI ranged from 3.4 to 71 n/h, with no association between OSA severity and LD. After surgery, normalization of LD was observed in most of the younger children (G1) and girls. In older children only 2 out of 9 improved. In 50% of the suspicious cases, LD also improved. Conclusion: There is a high prevalence of LD in OSAS children, with partial improvement after adenotonsillectomy, tending to be better in younger ones and girls.