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Abstract
To assess the impact of sleep-associated gas exchange abnormalities (SAGEA) on school
academic performance in children.
Prospective study.
Urban public elementary schools.
Two hundred ninety-seven first-grade children whose school performance was in the
lowest 10th percentile of their class ranking.
Children were screened for obstructive sleep apnea syndrome at home using a detailed
parental questionnaire and a single night recording of pulse oximetry and transcutaneous
partial pressure of carbon dioxide. If SAGEA was diagnosed, parents were encouraged
to seek medical intervention for SAGEA. School grades of all participating children
for the school year preceding and after the overnight study were obtained.
SAGEA was identified in 54 children (18.1%). Of these, 24 underwent surgical tonsillectomy
and adenoidectomy (TR), whereas in the remaining 30 children, parents elected not
to seek any therapeutic intervention (NT). Overall mean grades during the second grade
increased from 2.43 +/- 0.17 (SEM) to 2.87 +/- 0.19 in TR, although no significant
changes occurred in NT (2.44 +/- 0.13 to 2.46 +/- 0.15). Similarly, no academic improvements
occurred in children without SAGEA.
SAGEA is frequently present in poorly performing first-grade students in whom it adversely
affects learning performance. The data suggest that a subset of children with behavioral
and learning disabilities could have SAGEA and may benefit from prospective medical
evaluation and treatment.