Visuomotor integration skills in children affected by obstructive sleep apnea syndrome: A case-control study

Introduction: Sleep related breathing disorders (SRBD) consist of frequent and repetitive episodes of pharyngeal obstruction during sleep, with consequent intermittent hypoxia, sleep architecture fragmentation, daytime sleepiness and/or behavioural problems and executive impairment in children. When untreated, SRBD and obstructive sleep apnea syndrome (OSA) mainly, may impact school performance, cognition, metabolism, and cardiovascular function. Aim of the present study is assessing the visuomotor integration skills in children affected by OSA. Materials and methods: 57 subjects affected by mild-to severe OSA, PSG diagnosed according to international diagnostic criteria, (31 males and 26 females) (mean age 10.8; SD ± 2.49) and 83 healthy children (45 males and 38 females) (mean age 9.95; SD ± 1.87; p = 0.725). All subjects underwent assessment of motor coordination skills with Movement-ABC tests and visual-motor integration ability with Visual Motor Integration (VMI) test. Results: The subjects with OSA show a worse average performances in all items of Movement ABC (p < 0.001) respect of controls. Specifically, children with OSAS show significantly higher values of total points (p < 0.001), manual dexterity (p < 0.001), ball skills (p < 0.001) and balance (p < 0.001). Accordingly, the average centile in OSA children at the MABC-test is significantly reduced compared with controls (p < 0.001). (Table 1) On the other hand, the VMI test evaluation among children with OSAS shows worst result in total Visuo-Motor Integration (p < 0.001), and in Motor Coordination sub-item (p < 0.001) than controls. (Table 1). Conclusion: Our results also support for children and adolescents the hypothesis that executive functioning deficits might be linked primarily to the degree of severity nocturnal hypoxemia rather than daytime sleepiness, although several other studies are needed.