Sleep-disordered breathing in children and adolescents with systemic Lupus erythematosus and its association with executive functioning

Abstract

The relationship between sleep-disordered breathing and executive functioning in children and adolescents with Systemic Lupus Erythematosus (SLE) has not been wellstudied, despite literature referring to sleep problems in individuals with SLE. The goals of this study were to examine whether sleep-disordered breathing was more prevalent in children and adolescents with SLE compared to controls, whether there was an association between sleep-disordered breathing and executive functioning, and whether certain risk factors moderated or mediated this relationship.The SLE group consisted of 22 participants whose parents completed the study questionnaires (M age = 15.5, SD = 2.70, range = 9 - 18) and of which 17 completed the cognitive testing. Twenty-four controls from an attempted demographically matched population completed a subset of the questionnaires (M age = 14.2, SD = 1.96, range = 9 - 17). Parents of those with and without SLE completed the Sleep Disorders Inventory for Students (SDIS). Parents of those with SLE also completed the Behavior Rating Inventory of Executive Function (BRIEF) and Depression and Anxiety in Youth Scale (DAYS). Participants with SLE completed the Delis-Kaplan Executive Function System Trail Making and Verbal Fluency tests and the Wechsler Intelligence Scale for Children-IV/Wechsler Adult Intelligence Scale-III Digit Span test. Disease activity and disease severity variables were collected by chart review.Results from an independent samples t-test indicated that the SLE sample did not exhibit more sleep-disordered breathing symptoms than controls. For the SLE group, correlation analyses indicated that sleep-disordered breathing symptoms were positively associated with the BRIEF Global Executive Composite score. Multiple regression analyses to determine moderation and mediation in the relationship between sleepdisordered breathing and executive dysfunction were not conducted because of a small sample size.This study suggests that sleep-disordered breathing is not a major health concern for children and adolescents with SLE, but those with more symptoms of sleepdisordered breathing may exhibit more executive functioning difficulties. This study also suggests that the BRIEF, SDIS, and DAYS questionnaires may be useful screening measures for use with this population. Given several methodological limitations, findings are preliminary. Further research is needed that incorporates larger samples.%%%%Ph.D., Clinical Psychology – Drexel University, 2008