Parent-reported deficits in executive function and sleep-disordered breathing in adolescent behavioral weight loss program participants.

Abstract

Objective Children and adolescents with obesity are at increased risk for developing sleep-disordered breathing (SDB), and SDB has been associated with cognitive deficits including executive dysfunction. The aim of this study was to examine the relationship between executive functioning and SDB among adolescents participating in a behavioral weight loss intervention. Methods Adolescents (n = 37) and their caregivers completed the Behavior Rating Inventory of Executive Function (BRIEF). Sleep was characterized by the Pediatric Sleep Questionnaire (PSQ). The Sleep-Related Breathing Disorder scale on the PSQ was used to classify participants as at risk or not at risk for SDB. The Pediatric Daytime Sleepiness Scale (PDSS) was also administered. Results Significant correlations were found between SDB and executive functioning (r = 0.75; p < 0.001). Significant differences were observed between adolescents classified as at risk or not at risk for SDB on the BRIEF parent-report form (F (1, 35) = 3.73; p < 0.01) which represented a large effect size (d = 1.73). However, self-ratings on the BRIEF were not different between groups (F (1, 35) = 1.24; p > 0.05). The PSQ was predictive of the PDSS as well as the composite BRIEF score while the inhibition scale of the BRIEF predicted weight loss at 1 year. Conclusions Overweight or obese adolescents participating in a behavioral weight loss program that were at increased risk for SDB were rated by caregivers as demonstrating clinically significant executive dysfunction. Furthermore, ratings of in-hibitory control predicted weight loss at 1 year.