Associations of Sleep-Related Outcomes with Behavioral and Emotional Functioning in Children with Overweight/Obesity
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AutorTorres López, Lucía Victoria; Cadenas Sánchez, Cristina; Hidalgo Migueles, Jairo; Ortega Porcel, Francisco Bartolomé
Lucia V. Torres-Lopez... [et al.]. Associations of Sleep-Related Outcomes with Behavioral and Emotional Functioning in Children with Overweight/Obesity, The Journal of Pediatrics, Volume 246, 2022, Pages 170-178.e2, ISSN 0022-3476, [https://doi.org/10.1016/j.jpeds.2022.03.006]
PatrocinadorSpanish Government; European Commission DEP2013-47540 DEP2016-79512-R DEP2017-91544-EXP RYC-2011-09011; Spanish Government FPU17/04802 FJC2018-037925-I FPU15/02645; University of Granada, Plan Propio de Investigacion 2016, Excellence actions: Units of Excellence, Scientific Excellence Unit on Exercise and Health; Consejeria de Conocimiento, Investigacion y Universidades; European Commission B-CTS-355-UGR18 SOMM17/6107/UGR; SAMID III network, RETICS - PNI + D + I 2017-2021 (Spain); ISCIII Sub-Directorate General for Research Assessment and Promotion; 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; Junta de Andalucia
Objective To evaluate the associations of parent-reported sleep-disordered breathing (SDB) and device-assessed sleep behaviors with behavioral and emotional functioning in pediatric patients with overweight/obesity. Study design A total of 109 children with overweight/obesity (mean age, 10.0 +/- 1.1 years) were included in this cross-sectional study. We used the Spanish version of the Pediatric Sleep Questionnaire (PSQ) to assess SDB and its subscales (ie, snoring, daytime sleepiness, and inattention/hyperactivity). Device-assessed sleep behaviors (ie, wake time, sleep onset time, total time in bed, total sleep time, and waking after sleep onset) were estimated using wrist-worn accelerometers. We used the Behavior Assessment System for Children, second edition to assess behavioral and emotional functioning (ie, clinical scale: aggressiveness, hyperactivity, behavior problems, attention problems, atypicality, depression, anxiety, retreat, and somatization; adaptive scale: adaptability, social skills, and leadership). Results SDB was positively associated with all clinical scale variables (all beta > 0.197, P <=.041) and with lower adaptability and leadership (all beta < -0.226, P < .021). Specifically, the PSQ subscale relating to daytime sleepiness was associated with higher attention problems, depression, anxiety, and retreat (all beta > 0.196, P .045) and lower adaptability (beta = -0.246, P = .011). The inattention/hyperactivity subscale was significantly associated with the entire clinical and adaptive scales (all beta > vertical bar 0.192 vertical bar, P <= .046) except for somatization. The snoring subscale and device-assessed sleep behaviors were not related to any behavioral or emotional functioning variables. Conclusions Our study suggests that SDB symptoms, but not device-assessed sleep behaviors, are associated with behavioral and emotional functioning in children with overweight/obesity. Specifically, daytime sleepiness, a potential SDB symptom, was related to higher attention problems, depression, anxiety, and retreat and lower adaptability.