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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.

Frontiers in Neurology
|August 30, 2017
PubMed

Insights

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.
Abstract

Keywords:
attention deficit hyperactivity disorderbehavior problemscognitionmediationsleep apneasleep-disordered breathingsnoring

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