Translational Medicine, Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada.
University of Toronto, Toronto, Ontario, Canada.
Sleep Breath. 2024 Mar;28(1):477-487. doi: 10.1007/s11325-023-02886-1. Epub 2023 Jul 25.
To evaluate the associations of OSA severity, snoring symptoms, subjective sleep quality, and daytime sleepiness with executive functioning and behaviors in children with obesity.
This was a cross-sectional study of children aged 8-18 years with obesity and symptoms suggestive of OSA. All participants underwent an overnight polysomnography and completed a set of questionnaires to assess their sleep-related breathing disordered (SRBD) symptoms [Pediatric Sleep Questionnaire (SRBD-PSQ)], sleep quality [Pittsburgh Sleep Quality Index (PSQI)], executive function [Behavior Rating Inventory of Executive Function (BRIEF)], and inattention and hyperactivity symptoms (Conners-3 Parent Short Form).
A total of 85 children (62% male, mean age: 13.9 ± 3.0 years) were included in this analysis, of whom 36, 16, and 33 were categorized into the non-OSA (obstructive apnea hypopnea index, OAHI < 1.5/h), mild OSA (OAHI 1.5-5/h), and moderate-severe OSA (OAHI ≥ 5/h) groups, respectively. Of 85 participants, 27 (32%) were classified with poor sleep quality (PSQI composite score ≥ 8). From multiple linear regression analyses, poor sleep quality and sleepiness were both independently associated with higher BRIEF behavioral regulation T-score, metacognition T-score, and global executive composite T-score in the fully adjusted model. In addition, poor sleep quality was also independently associated with higher Conners-3 inattention and executive functioning T-scores, while greater sleepiness was also associated with a higher learning problem T-score. The presence of OSA and snoring were not associated with any cognitive outcomes.
Subjective sleep quality and daytime sleepiness, but not OSA severity and snoring symptoms, were independently associated with executive functioning and behavioral problems in children with obesity.
评估阻塞性睡眠呼吸暂停（OSA）严重程度、打鼾症状、主观睡眠质量和日间嗜睡与肥胖儿童执行功能和行为之间的关系。
这是一项横断面研究，纳入了年龄在 8-18 岁、有肥胖症且有 OSA 症状的儿童。所有参与者均接受了一整夜的多导睡眠图检查，并完成了一套问卷，以评估其睡眠相关呼吸障碍（SRBD）症状[小儿睡眠问卷（SRBD-PSQ）]、睡眠质量[匹兹堡睡眠质量指数（PSQI）]、执行功能[行为评定量表（BRIEF）]以及注意力不集中和多动症状（Conners-3 父母简表）。
共有 85 名儿童（62%为男性，平均年龄：13.9±3.0 岁）纳入本分析，其中 36、16 和 33 名儿童分别被归类为非 OSA（阻塞性呼吸暂停低通气指数，OAHI<1.5/h）、轻度 OSA（OAHI 1.5-5/h）和中重度 OSA（OAHI≥5/h）组。85 名参与者中，27 名（32%）被归类为睡眠质量差（PSQI 总分≥8）。多项线性回归分析显示，在完全调整模型中，睡眠质量差和嗜睡均与 BRIEF 行为调节 T 评分、元认知 T 评分和总体执行功能复合 T 评分升高独立相关。此外，睡眠质量差还与 Conners-3 注意力不集中和执行功能 T 评分升高独立相关，而嗜睡与学习问题 T 评分升高也相关。OSA 和打鼾的存在与任何认知结果均无关。
主观睡眠质量和日间嗜睡，但不是 OSA 严重程度和打鼾症状，与肥胖儿童的执行功能和行为问题独立相关。
