Original ArticleRelationships among Obstructive Sleep Apnea, Anthropometric Measures, and Neurocognitive Functioning in Adolescents with Severe Obesity
Section snippets
Methods
The study was approved by the University of Pittsburgh’s Institutional Review Board and was performed in the Pediatric Clinical and Translational Research Center at Children’s Hospital of Pittsburgh. Patients referred for evaluation of obesity who met the study criteria were invited to participate. After obtaining informed assent/consent, we studied 37 severely obese (BMI >97th percentile), nondiabetic, otherwise healthy adolescents (eligible age range, 12-18 years; mean age, 14.5 ± 1.7 years;
Results
Mean total sleep time was 420 ± 5.3 minutes (range, 354-484 minutes). Thirty-three participants snored (90%). Twenty had no evidence of apnea/hypopnea (AHI <1.5), and 17 had some degree of OSA (9 with an AHI ≥1.5 to <5, 2 with an AHI ≥5 to <10, and 6 with an AHI ≥10). AHI was positively associated with the arousal index (r = 0.45; P = .005) and negatively associated with sleep time (r = −0.34; P = .039), sleep efficiency (r = −0.66; P < .001), and mean and minimum oxygen saturation (rmean = −0.73, P < .001 and r
Discussion
We report that in severely obese adolescents, sleep fragmentation is associated with reduced psychomotor efficiency and lower scores on standardized vocabulary testing, and poorer sleep efficiency is associated with poorer memory recall and lower spelling scores. These findings indicate that clinically unrecognized sleep disruption leading to poorer sleep quality has implications for the neurocognitive functioning of obese adolescents. Having evidence of OSA also appears to be associated with
References (19)
- et al.
Obesity and obstructive sleep apnea in children
Paediatr Respir Rev
(2006) - et al.
Pediatric obstructive sleep apnea syndrome
Clin Chest Med
(2010) - et al.
Obstructive sleep apnea-hypopnea and neurocognitive functioning in the Sleep Heart Health Study
Sleep Med
(2006) - et al.
Normal polysomnographic respiratory values in children and adolescents
Chest
(2004) - et al.
Cognitive and academic functions are impaired in children with all severities of sleep-disordered breathing
Sleep Med
(2011) - et al.
Sleep-disordered breathing symptoms are associated with poorer cognitive function in 5-year-old children
J Pediatr
(2004) - et al.
Neurocognitive deficits in morbidly obese children with obstructive sleep apnea
J Pediatr
(1995) - et al.
Obesity and respiratory diseases in childhood
Clin Chest Med
(2009) - et al.
Cardiovascular risk factors and excess adiposity among overweight children and adolescents: the Bogalusa Heart Study
J Pediatr
(2007)
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Supported by the Pittsburgh Foundation (grant M2007-0064, to T.H.), the Children’s Hospital of Pittsburgh Research Advisory Committee (to T.H.), a National Institutes of Health Postdoctoral Training Fellowship (T32-HD049354, to D.R.), a National Institutes of Health Career Development Award (K12-HD043441/K23HD061598, to D.R.), the State Tobacco Fund–Pittsburgh Mind-Body Center (HL076852/076858, to D.R.), the US Public Health Service (grants R03HD057532, to T.H.; K24-HD01357, to S.A.; and K12-DK063704, to T.H. and S.A.), and the Pediatric Clinical and Translational Research Center at Children’s Hospital of Pittsburgh (National Institutes of Health/National Center for Research Resources/Clinical and Translational Science Awards grant UL1-RR024153). The authors declare no conflicts of interest.