title: Neurobehavioural correlates in older children and adolescents with obesity and obstructive sleep apnoea.
abstract: OBJECTIVE
  The relationship between obstructive sleep apnoea (OSA) and poorer neurobehavioural outcomes in school-age children is well established, but the relationship in obese children and adolescents, in whom OSA is more common, is not so well established. We aimed to investigate this relationship in 10-18-year-olds.
  
  
  METHODS
  Thirty-one participants with a mean body mass index (BMI) of 32.3 ± 4.9 enrolled. BMI-for-age cut-offs were used to define obesity. Participants underwent polysomnography and were classified into OSA (apnoea-hypopnoea index (AHI) > 2 per hour) and non-OSA (AHI ≤ 2) groups. Intelligence, memory and learning, academic achievement, behaviour and executive functioning were assessed using the Wechsler Abbreviated Scale of Intelligence, Wide Range Assessment of Memory and Learning 2, Wechsler Individual Achievement Test II (WIAT-II), Behavioural Assessment System for Children 2 and Behaviour Rating Inventory of Executive Function, respectively.
  
  
  RESULTS
  Forty-eight per cent (15/31) were classified as having OSA, and 52% (16/31) as non-OSA. The obese cohort performed below the average of normative data on several neurobehavioural measures. WIAT-II maths scores were significantly lower (P = 0.034) in the OSA group than in the non-OSA group (means 84.5 vs. 94.6, respectively), losing significance after adjustment for IQ, age and gender. Self-reported school problems were significantly worse in the OSA group before and after multivariate adjustment (P = 0.010, Cohen's d = 1.02). No other significant differences were found.
  
  
  CONCLUSIONS
  Results suggest that OSA may increase risk for some poorer educational and behavioural outcomes. The findings are reasonably consistent with and add to the evidence base of the few studies that have explored this relationship.
authors.affiliation: Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand.
authors.forename: Evan
authors.initials: E
authors.lastname: Tan
authors.forename: Dione
authors.initials: D
authors.lastname: Healey
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Schaughency
authors.forename: Patrick
authors.initials: P
authors.lastname: Dawes
authors.forename: Barbara
authors.initials: B
authors.lastname: Galland
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D015992:Body Mass Index; D002648:Child; D002653:Child Behavior Disorders / Q000209:etiology*; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000150:complications / Q000523:psychology*; D017286:Polysomnography; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000523:psychology*
keywords: academic performance; behaviour; obesity; psychological functioning; sleep apnoea