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Parent-Reported Behavioral and Psychiatric Problems Mediate the Relationship between Sleep-Disordered Breathing and
Dale L Smith1,2, David Gozal3, Scott J Hunter3,4
1Public Health Sciences, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, Chicago, IL, United States.
Sleep-disordered breathing (SDB) in children impacts cognitive function indirectly through behavioral problems. Addressing these behavioral issues may improve cognitive outcomes in affected children.
Area of Science:
- Pediatric Sleep Medicine
- Neurodevelopmental Disorders
- Child Psychology
Background:
- Sleep-disordered breathing (SDB) is linked to increased risks of cognitive, behavioral, and psychiatric issues in children.
- The mediating role of behavioral problems between SDB and cognitive functioning requires critical examination.
Purpose of the Study:
- To investigate the mediational role of behavior and psychiatric problems in the relationship between SDB and cognitive functioning in children.
- To explore direct and indirect effects of SDB on cognitive outcomes.
Main Methods:
- Analysis of a community-based cohort of 1,115 children with polysomnography, cognitive, and behavioral assessments.
- Utilized structural modeling and mediation approaches (propensity score weighting, resampling).
- Adjusted for age, sex, BMI z-score, and asthma status; employed multiple SDB definitions.
Main Results:
- Significant indirect effects of SDB on cognition were found through behavior problems across all mediation models.
- Direct effects of SDB on cognitive functioning were not significant.
- Findings remained consistent across different mediation procedures and SDB/behavior/cognition criteria.
Conclusions:
- Cognitive functioning deficits associated with SDB in children appear to be mediated by behavioral problems.
- Early identification of attentional or behavioral pathology may serve as a susceptibility biomarker for cognitive deficits in SDB.
- Behavioral interventions could be crucial for mitigating cognitive impairments in pediatric SDB.
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