{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T12:29:11Z","timestamp":1793881751736,"version":"4.7.0"},"reference-count":26,"publisher":"American Medical Association (AMA)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Otolaryngol Head Neck Surg"],"published-print":{"date-parts":[[2025,2,1]]},"abstract":"<jats:sec id=\"ab-ooi240092-4\"><jats:title>Introduction<\/jats:title><jats:p>Mild sleep-disordered breathing (mSDB) in children is associated with both neurobehavioral morbidity and reduced quality of life (QOL). However, the association between symptom burden and QOL with executive function is not well understood, and it is not known whether QOL and symptom burden may help identify children with neurocognitive dysfunction.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi240092-5\"><jats:title>Objective<\/jats:title><jats:p>To assess associations among executive function, QOL, and symptom burden in children with mSDB.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi240092-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This cross-sectional study was a secondary analysis of the multicenter Pediatric Adenotonsillectomy Trial for Snoring, which included children aged 3 to 12 years randomized to watchful waiting or adenotonsillectomy for mSDB (snoring and an obstructive apnea-hypopnea index &amp;amp;lt;3) between June 29, 2016, and February 1, 2021. The data for this report were analyzed between December 22, 2020, and October 3, 2024.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi240092-7\"><jats:title>Exposure<\/jats:title><jats:p>Pediatric mSDB.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi240092-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>Quality of life was assessed using the Obstructive Sleep Apnea\u201318 (OSA-18), and symptom burden was assessed using the Pediatric Sleep Questionnaire\u2013Sleep-Related Breathing Disorder Scale (PSQ-SRBD). Executive function, including self-control and working memory, was measured using the Behavior Rating Inventory of Executive Function Global Executive Composite (BRIEF GEC), and inhibitory control and sustained attention were measured by the GoNoGo vigilance test. Partial Pearson correlations and multiple linear regression models were used to assess the associations among QOL, symptoms, and executive function.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi240092-9\"><jats:title>Results<\/jats:title><jats:p>The sample included 459 children (mean [SD] age, 6.1 [2.3] years; 230 female [50.1%]). Moderate correlations were found between the BRIEF GEC and the PSQ-SRBD and OSA-18 (<jats:italic>r<\/jats:italic>\u2009=\u20090.58 [95% CI, 0.51-0.64] and 0.59 [95% CI, 0.52-0.64], respectively). After adjusting for age, sex, race and ethnicity, body mass index percentile, household income, maternal education, attention-deficit\/hyperactivity disorder, test characteristics, and disease severity, both OSA-18 and PSQ-SRBD scores were associated with the BRIEF GEC (\u03b2\u2009=\u20090.41 [95% CI, 0.36-0.47] and 3.66 [95% CI, 3.17-4.15], respectively). In the fully adjusted model, PSQ-SRBD was also associated with GoNoGo inhibitory control (\u03b2\u2009=\u2009\u22120.04 [95% CI, \u22120.08 to \u22120.01]) and sustained attention (\u03b2\u2009=\u2009\u22120.05 [95% CI, \u22120.10 to \u22120.01]).<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi240092-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>In this study, disease-specific QOL and symptom burden were associated with executive function in children with mSDB. These findings may be useful in identifying those children who are at risk for neurocognitive dysfunction.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamaoto.2024.4373","type":"journal-article","created":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T16:02:04Z","timestamp":1734624124000},"page":"151","source":"Crossref","is-referenced-by-count":15,"title":["Symptoms, Quality of Life, and Executive Function in Children Who Snore"],"prefix":"10.1001","volume":"151","author":[{"given":"Phoebe K.","family":"Yu","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, Massachusetts Eye and Ear, Boston"},{"name":"Division of Sleep and Circadian Disorders, Brigham and Women\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaitlyn","family":"Cook","sequence":"additional","affiliation":[{"name":"Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, Massachusetts"},{"name":"Program in Statistical and Data Sciences, Smith College, Northampton, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ignacio E.","family":"Tapia","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pulmonary and Sleep Medicine, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristie R.","family":"Ross","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University Hospitals Rainbow Babies & Children\u2019s, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University Hospitals Rainbow Babies & Children\u2019s, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raouf","family":"Amin","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacey L.","family":"Ishman","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio"},{"name":"Division of Otolaryngology\u2013Head and Neck Surgery, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fauziya","family":"Hassan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Michigan, Ann Arbor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald D.","family":"Chervin","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Michigan, Ann Arbor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, University of Texas Southwestern, Dallas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ron B.","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, University of Texas Southwestern, Dallas"},{"name":"Department of Pediatrics, University of Texas Southwestern, Dallas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Stone","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Children\u2019s Hospital of The King\u2019s Daughters, Norfolk, Virginia"},{"name":"Department of Pediatric Sleep Medicine, Eastern Virginia Medical School, Norfolk, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. Gerry","family":"Taylor","sequence":"additional","affiliation":[{"name":"Abigail Wexner Research Institute, Nationwide Children\u2019s Hospital, Columbus, Ohio"},{"name":"Department of Pediatrics, The Ohio State University, Columbus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerilynn","family":"Radcliffe","sequence":"additional","affiliation":[{"name":"Division of Developmental and Behavioral Pediatrics, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Redline","sequence":"additional","affiliation":[{"name":"Division of Sleep and Circadian Disorders, Brigham and Women\u2019s Hospital, Boston, Massachusetts"},{"name":"Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina M.","family":"Baldassari","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, 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