Early Surgery Reduces Psychiatric and Learning Disorder Risk in Pediatric Sleep‐Disordered Breathing

ABSTRACT Objective To determine whether the type and timing of intervention for pediatric sleep‐disordered breathing (SDB) affect the risk of developing neuropsychiatric and learning disorders. Methods A retrospective cohort study using TriNetX, from January 2016 to March 2025, was conducted. Patients < 18 years with a diagnosis of SDB were included. Propensity score matching (1:1) based on demographics and concomitant diagnoses was performed for three comparisons: untreated versus surgical management ( n = 152,653), untreated versus non‐surgical management ( n = 8,634), and surgical versus non‐surgical management ( n = 8,873). The incidence of anxiety, depressive, eating, behavioral, and learning disorders at 1 year, 5 years, and anytime post‐intervention was recorded. In surgical patients, outcomes were also stratified by timing of surgery: within versus beyond 3, 6, and 12 months of diagnosis. Results Compared to surgery, no treatment was associated with significantly elevated risk of anxiety (risk ratio [RR] 1.44), depressive (RR 1.71), eating (RR 1.27), behavioral (RR 1.31), and learning disorders (RR 1.39) at 1 year. Compared to surgery, non‐surgical management significantly increased the risk of anxiety (RR 2.27), depressive (RR 1.69), behavioral (RR 1.24), and learning disorders (RR 2.72) at 1 year. Similar trends were observed at 5 years. Surgery within 6 months significantly reduced the risk of anxiety (RR 1.06), eating (RR 1.38), behavioral (RR 1.12), and learning disorders (RR 1.14) ( p < 0.05 for all comparisons). Conclusion Early surgical intervention for pediatric SDB is associated with significantly lower risks of neuropsychiatric and learning disorders compared to delayed surgery, non‐surgical management, or no treatment, necessitating validation through future prospective trials. Level of Evidence 3.