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Associations of Sleep-Related Outcomes with Behavioral and Emotional Functioning in Children with Overweight/Obesity

Lucia V Torres-Lopez1, Cristina Cadenas-Sanchez2, Jairo H Migueles3

  • 1PROFITH (PROmoting FITness and Health through physical activity) research group, Sport and Health University Research Institute, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain.

The Journal of Pediatrics
|March 12, 2022
PubMed

Insights

Sleep-disordered breathing (SDB) symptoms, particularly daytime sleepiness, are linked to behavioral and emotional issues in children with overweight/obesity. Device-measured sleep patterns did not show similar associations, highlighting SDB as a key factor.

Area of Science:

  • Pediatric Health
  • Sleep Medicine
  • Behavioral Science

Background:

  • Pediatric overweight/obesity is a growing concern associated with various health issues.
  • Sleep-disordered breathing (SDB) is prevalent in children and can impact neurodevelopment.
  • Understanding the link between sleep disturbances and behavioral outcomes is crucial for effective interventions.

Purpose of the Study:

  • To investigate the association between parent-reported sleep-disordered breathing (SDB) and objectively measured sleep behaviors with emotional and behavioral functioning in pediatric patients with overweight/obesity.

Main Methods:

  • A cross-sectional study included 109 children with overweight/obesity (mean age 10.0 years).
  • Parental reports of SDB and its symptoms (snoring, daytime sleepiness, inattention/hyperactivity) were collected using the Pediatric Sleep Questionnaire (PSQ).
  • Objective sleep behaviors (wake time, sleep onset, total sleep time) were assessed using wrist-worn accelerometers, and behavioral/emotional functioning was evaluated using the Behavior Assessment System for Children, second edition.

Main Results:

  • Parent-reported SDB symptoms were positively associated with all measured clinical behavioral variables and negatively with adaptability and leadership.
  • Daytime sleepiness was linked to increased attention problems, depression, anxiety, retreat, and reduced adaptability.
  • The inattention/hyperactivity subscale of the PSQ correlated with most behavioral and emotional functioning variables, except somatization. Snoring and device-assessed sleep behaviors showed no significant associations.

Conclusions:

  • Sleep-disordered breathing symptoms, especially daytime sleepiness, are significantly associated with poorer behavioral and emotional functioning in children with overweight/obesity.
  • Objective sleep metrics from accelerometers did not reveal similar associations, suggesting parent-reported SDB symptoms are more relevant for these outcomes.
  • These findings underscore the importance of screening for SDB symptoms in overweight/obese children to address potential behavioral and emotional challenges.
Abstract

Keywords:
accelerometerchildhood obesitymental healthobstructive sleep apneasleep durationsleep quality

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