Does sleep‑disordered breathing add to impairments in academic performance and brain structure usually observed in children with overweight/obesity?
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AuthorTorres López, Lucía Victoria; Cadenas Sánchez, Cristina; Hidalgo Migueles, Jairo; Esteban Cornejo, Irene; Molina García, Pablo; Catena Martínez, Andrés; Ortega Porcel, Francisco Bartolomé
PreadolescentsChildhood obesityObstructive sleep apneaAcademic achievementBrain health
Torres-Lopez, L.V... [et al.]. Does sleep-disordered breathing add to impairments in academic performance and brain structure usually observed in children with overweight/obesity?. Eur J Pediatr (2022). [https://doi.org/10.1007/s00431-022-04403-0]
SponsorshipUniversidad de Granada/CBUA; Spanish Government European Commission; Spanish Government DEP201347540 DEP2016-79512-R DEP2017-91544-EXP RYC-201109011; Spanish Government FPU17/04802 FPU15/02645 FJC2018-037925-I RYC2019-027287-I; University of Granada, Plan Propio de Investigacion 2016, Excellence actions: Units of Excellence, Scientific Excellence Unit on Exercise and Health (UCEES); Junta de Andalucia European Commission SOMM17/6107/UGR; SAMID III network, RETICS - PNI + D + I 2017-2021 (Spain); ISCIII-Sub-Directorate General for Research Assessment and Promotion; European Commission RD16/0022; EXERNET Research Network on Exercise and Health DEP2005-00046/ACTI 09/UPB/19 45/UPB/20 27/UPB/21; European Commission 667302; HL-PIVOT network-Healthy Living for Pandemic Event Protection; Andalusian Operational Programme; European Regional Development Funds (ERDF in English, FEDER in Spanish) B-CTS-355-UGR18
Approximately 4–11% of children suffer from sleep-disordered breathing (SDB), and children with obesity are at increased risk. Both obesity and SDB have been separately associated with poorer brain health, yet whether SDB severity affects brain health in children with obesity remains unanswered. This study aimed to examine associations of SDB severity with academic performance and brain structure (i.e., total brain and gray and white matter volumes and gray matter volume in the hippocampus) in children with overweight/obesity. One hundred nine children aged 8–12 years with overweight/obesity were included. SDB severity and its subscales (i.e., snoring, daytime sleepiness, and inattention/hyperactivity) were evaluated via the Pediatric Sleep Questionnaire (PSQ), and academic performance was evaluated with the Woodcock-Muñoz standardized test and school grades. Brain structure was assessed by magnetic resonance imaging. SDB severity was not associated with academic performance measured by the standardized test (all |β|> 0.160, P > 0.076), yet it was associated with the school grade point average (β = -0.226, P = 0.007) and natural and social science grades (β = -0.269, P = 0.024). Intention/hyperactivity seemed to drive these associations. No associations were found between SDB severity and the remaining school grades (all β < -0.188, P > 0.065) or brain volumes (all P > 0.05). Conclusion: Our study shows that SDB severity was associated with lower school grades, yet it was not associated with the standardized measurement of academic performance or with brain volumes in children with overweight/obesity. SDB severity may add to academic problems in children beyond the effects contributed by overweight/obesity status alone.