Abstract
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.What is Known:• Sleep-disordered breathing (SDB) may affect brain structure and academic performance in children.• Children with overweight/obesity are at higher risk for the development of SDB, yet the comorbid obesity-SDB relationship with brain health has not been investigated thus far.What is New:• To our knowledge, this is the first study examining the associations of comorbid obesity-SDB severity with brain volumes and academic performance in children.• SDB symptoms may adversely affect academic performance at school in children with overweight/obesity, beyond the effects of weight status alone.
Highlights
Pediatric obstructive sleep-disordered breathing (SDB) has been recognized as a common health problem [1]
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
The Pediatric Sleep Questionnaire (PSQ) inattention/hyperactivity subscale was the only subscale associated with school grades
Summary
Pediatric obstructive sleep-disordered breathing (SDB) has been recognized as a common health problem [1]. The European Respiratory Society Task Force defined obstructive SDB as a set of respiratory tract dysfunctions during sleep, which are characterized by snoring and/or increased effort to breathe caused by a narrowing of the pharynx and increased airway resistance [2]. SDB affects approximately 4–11% of children, with a range of severities from primary snoring to obstructive sleep apnea (OSA) [3, 4]. In a previous study including children 6–15 years of age, those with obesity were at higher risk for SDB (20.8%) than their normal-weight peers (6.3%) [4]. Among children with SDB, obesity has been associated with higher SDB severity [5, 6].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
