title: A mediation model linking body weight, cognition, and sleep-disordered breathing.
abstract: BACKGROUND
  Academic success involves the ability to use cognitive skills in a school environment. Poor academic performance has been linked to disrupted sleep associated with sleep-disordered breathing (SDB). In parallel, poor sleep is associated with increased risk for obesity, and weight management problems have been linked to executive dysfunction, suggesting that interactions may be operational between SDB and obesity to adversely affect neurocognitive outcomes.
  
  
  OBJECTIVE
  To test whether mediator relationships exist between body weight, SDB, and cognition.
  
  
  METHODS
  Structural equation modeling was conducted on data from 351 children in a community-based cohort assessed with the core subtests of the Differential Abilities Scales after an overnight polysomnogram. Body mass index, apnea-hypopnea index, and cognitive abilities were modeled as latent constructs.
  
  
  RESULTS
  In a sample of predominantly white children 6 to 10 years of age, SDB amplified the adverse cognitive and weight outcomes by 0.55- to 0.46-fold, respectively. Weight amplified the risk by 0.39- to 0.40-fold for SDB and cognitive outcomes, respectively. Poor ability to perform complex mental processing functions increased the risk of adverse weight and SDB outcomes by 2.9- and 7.9-fold, respectively.
  
  
  CONCLUSIONS
  Cognitive functioning in children is adversely affected by frequent health-related problems, such as obesity and SDB. Furthermore, poorer integrative mental processing may place a child at a bigger risk for adverse health outcomes.
authors.affiliation: Department of Pediatrics, Pritzker School of Medicine, The University of Chicago, IL 60637, USA. karenspruyt@uchicago.edu
authors.forename: Karen
authors.initials: K
authors.lastname: Spruyt
authors.forename: David
authors.initials: D
authors.lastname: Gozal
mesh_terms: D000465:Algorithms; D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D003071:Cognition; D003072:Cognition Disorders / Q000209:etiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D009765:Obesity / Q000150:complications*; D017286:Polysomnography; D012307:Risk Factors; D012494:Sampling Studies; D012574:Schools; D012891:Sleep Apnea Syndromes / Q000150:complications* / Q000209:etiology
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