A1 Journal article (refereed)
Does sleep-disordered breathing add to impairments in academic performance and brain structure usually observed in children with overweight/obesity? (2022)

Torres-Lopez, L. V., Cadenas-Sanchez, C., Migueles, J. H., Esteban-Cornejo, I., Molina-Garcia, P., Hillman, C. H., Catena, A., & Ortega, F. B. (2022). Does sleep-disordered breathing add to impairments in academic performance and brain structure usually observed in children with overweight/obesity?. European Journal of Pediatrics, 181, 2055-2065. https://doi.org/10.1007/s00431-022-04403-0

JYU authors or editors

Publication details

All authors or editorsTorres-Lopez, Lucia V.; Cadenas-Sanchez, Cristina; Migueles, Jairo H.; Esteban-Cornejo, Irene; Molina-Garcia, Pablo; Hillman, Charles H.; Catena, Andres; Ortega, Francisco B.

Journal or seriesEuropean Journal of Pediatrics



Publication year2022

Publication date10/02/2022


Pages range2055-2065


Publication countryGermany

Publication languageEnglish


Publication open accessOpenly available

Publication channel open accessPartially open access channel

Publication is parallel published (JYX)https://jyx.jyu.fi/handle/123456789/89624


Approximately 4–11% of children suffer from sleep-disordered breathing (SDB), and children with obesity are at increased risk. Both obesity and SDB have been separately associated with poorer brain health, yet whether SDB severity affects brain health in children with obesity remains unanswered. This study aimed to examine associations of SDB severity with academic performance and brain structure (i.e., total brain and gray and white matter volumes and gray matter volume in the hippocampus) in children with overweight/obesity. One hundred nine children aged 8–12 years with overweight/obesity were included. SDB severity and its subscales (i.e., snoring, daytime sleepiness, and inattention/hyperactivity) were evaluated via the Pediatric Sleep Questionnaire (PSQ), and academic performance was evaluated with the Woodcock-Muñoz standardized test and school grades. Brain structure was assessed by magnetic resonance imaging. SDB severity was not associated with academic performance measured by the standardized test (all |β|> 0.160, P > 0.076), yet it was associated with the school grade point average (β = -0.226, P = 0.007) and natural and social science grades (β = -0.269, P = 0.024). Intention/hyperactivity seemed to drive these associations. No associations were found between SDB severity and the remaining school grades (all β < -0.188, P > 0.065) or brain volumes (all P > 0.05).

Conclusion: Our study shows that SDB severity was associated with lower school grades, yet it was not associated with the standardized measurement of academic performance or with brain volumes in children with overweight/obesity. SDB severity may add to academic problems in children beyond the effects contributed by overweight/obesity status alone.

Keywordssleep apnea syndromesleeprespirationbraincognitionoverweightobesitychildren (age groups)

Free keywordspreadolescents; childhood obesity; obstructive sleep apnea; academic achievement; brain health

Contributing organizations

Ministry reportingYes

Reporting Year2023

JUFO rating1

Last updated on 2024-14-06 at 23:27