The Association Between Sleep Disordered Breathing, Academic Grades, and Cognitive and Behavioral Functioning Among Overweight Subjects During Middle to Late Childhood
The Association Between Sleep Disordered Breathing, Academic Grades, and Cognitive and Behavioral Functioning Among Overweight Subjects During Middle to Late Childhood
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DOI：
10.1093/sleep/33.11.1447
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发表时间：
2010-11-01
期刊：
影响因子：
5.6
通讯作者：
Amin, Raouf
中科院分区：
文献类型：
--
作者：
Beebe, Dean W.;Ris, M. Douglas;Amin, Raouf
研究目标：(1)确定睡眠障碍呼吸(SDB)与儿童中期到后期的行为功能、认知测试分数和学校成绩之间的关系，这是SDB文献中研究不足的发展时期，以及(2)澄清SDB和学校成绩之间的联系是否通过认知或行为功能缺陷来调节。设计：横断面相关性研究。地点：办公室/医院，参与者：163名10-16.9岁的超重受试者根据他们夜间多导睡眠图中的阻塞性呼吸暂停低通气指数(AHI)和父母报告的打鼾症分为4组：中-重度阻塞性睡眠呼吸暂停综合征(AHI>；5，42例，轻度阻塞性睡眠呼吸暂停综合征(OSA)(AHI=1-5，n=58)，打鼾者(AHI<；1+鼾症，n=26)，无鼾症(AHI<；1，无鼾症，n=37)。测量：住院患者通宵多导睡眠图，家长和教师报告的学习成绩和睡眠，家长和教师报告的白天行为，以及办公室神经心理测试。结果：4组在学业成绩、家长和教师报告的行为，特别是注意力和学习问题上有显著差异。在调整了受试者的性别、种族、社会经济地位和学校夜间睡眠时间后，这些发现仍然具有重要意义。与SDB的联系仅限于真实世界中行为困难的报告，而不延伸到基于办公室的神经心理测试。二次分析的结果与SDB通过其对行为功能的影响影响学校成绩的因果模型一致，但不能确定。结论：儿童中后期的SDB与行为功能的重要方面有关，特别是注意力不集中和学习困难，可能导致学校显著的功能障碍。
Study Objectives: (1) to determine the associations of sleep disordered breathing (SDB) with behavioral functioning, cognitive test scores, and school grades during middle- to late-childhood, an under-researched developmental period in the SDB literature, and (2) to clarify whether associations between SDB and school grades are mediated by deficits in cognitive or behavioral functioning.Design: Cross-sectional correlative study.Setting: Office/hospital, plus reported functioning at home and at school.Participants: 163 overweight subjects aged 10-16.9 years were divided into 4 groups based upon their obstructive apnea+hypopnea index (AHI) during overnight polysomnography and parent report of snoring: Moderate-Severe OSA (AHI > 5, n = 42), Mild OSA (AHI = 1-5, n = 58), Snorers (AHI < 1 + snoring, n =, 26), and No SDB (AHI < 1 and nonsnoring, n = 37).Measurements: Inpatient overnight polysomnography, parent- and self-report of school grades and sleep, parent- and teacher-report of daytime behaviors, and office-based neuropsychological testing.Results: The 4 groups significantly differed in academic grades and parent- and teacher-reported behaviors, particularly inattention and learning problems. These findings remained significant after adjusting for subject sex, race, socioeconomic status, and school night sleep duration. Associations with SDB were confined to reports of behavioral difficulties in real-world situations, and did not extend to office-based neuropsychological tests. Findings from secondary analyses were consistent with, but could not definitively confirm, a causal model in which SDB affects school grades via its impact on behavioral functioning.Conclusions: SDB during middle- to late-childhood is related to important aspects of behavioral functioning, especially inattention and learning difficulties, that may result in significant functional impairment at school.