A1 Journal article (refereed)
Associations of Sleep-Related Outcomes with Behavioral and Emotional Functioning in Children with Overweight/Obesity (2022)

Torres-Lopez, L. V., Cadenas-Sanchez, C., Migueles, J. H., Henriksson, P., Löf, M., & Ortega, F. B. (2022). Associations of Sleep-Related Outcomes with Behavioral and Emotional Functioning in Children with Overweight/Obesity. Journal of Pediatrics, 246, 170-178.e2. https://doi.org/10.1016/j.jpeds.2022.03.006

JYU authors or editors

Publication details

All authors or editorsTorres-Lopez, Lucia V.; Cadenas-Sanchez, Cristina; Migueles, Jairo H.; Henriksson, Pontus; Löf, Marie; Ortega, Francisco B.

Journal or seriesJournal of Pediatrics



Publication year2022

Publication date10/03/2022


Pages range170-178.e2

PublisherElsevier BV

Publication countryUnited States

Publication languageEnglish


Publication open accessOpenly available

Publication channel open accessPartially open access channel

Publication is parallel published (JYX)https://jyx.jyu.fi/handle/123456789/89790


To evaluate the associations of parent-reported sleep-disordered breathing (SDB) and device-assessed sleep behaviors with behavioral and emotional functioning in pediatric patients with overweight/obesity.

Study design
A total of 109 children with overweight/obesity (mean age, 10.0 ± 1.1 years) were included in this cross-sectional study. We used the Spanish version of the Pediatric Sleep Questionnaire (PSQ) to assess SDB and its subscales (ie, snoring, daytime sleepiness, and inattention/hyperactivity). Device-assessed sleep behaviors (ie, wake time, sleep onset time, total time in bed, total sleep time, and waking after sleep onset) were estimated using wrist-worn accelerometers. We used the Behavior Assessment System for Children, second edition to assess behavioral and emotional functioning (ie, clinical scale: aggressiveness, hyperactivity, behavior problems, attention problems, atypicality, depression, anxiety, retreat, and somatization; adaptive scale: adaptability, social skills, and leadership).

SDB was positively associated with all clinical scale variables (all β > 0.197, P ≤ .041) and with lower adaptability and leadership (all β < −0.226, P < .021). Specifically, the PSQ subscale relating to daytime sleepiness was associated with higher attention problems, depression, anxiety, and retreat (all β > 0.196, P ≤ .045) and lower adaptability (β = −0.246, P = .011). The inattention/hyperactivity subscale was significantly associated with the entire clinical and adaptive scales (all β > |0.192|, P ≤ .046) except for somatization. The snoring subscale and device-assessed sleep behaviors were not related to any behavioral or emotional functioning variables.

Our study suggests that SDB symptoms, but not device-assessed sleep behaviors, are associated with behavioral and emotional functioning in children with overweight/obesity. Specifically, daytime sleepiness, a potential SDB symptom, was related to higher attention problems, depression, anxiety, and retreat and lower adaptability.

Keywordsobesityoverweightchildren (age groups)sleepsleep disordersrespirationsleep apnea syndromemental well-beingattentionfatigue (biological phenomena)measuring instruments (indicators)

Free keywordschildhood obesity; obstructive sleep apnea; sleep duration; sleep quality; mental health; accelerometer

Contributing organizations

Ministry reportingYes

Reporting Year2023

JUFO rating2

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