Cognitive Performance in Adolescent Boys with and without Obesity and Obstructive Sleep Apnea-Hypopnea Syndrome: A Pilot Study

Objective — This pilot study aimed to examine how cognitive performance of obese and nonobese adolescent boys with obstructive sleep apnea-hypopnea syndrome (OSAHS) is associated with anthropometric parameters and OSAHS-related indicators. Material and Methods — The study included 35 obese and 20 normal-weight (NW) middle-adolescent boys with OSAHS, as well as 20 matched controls. The Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV), was used to assess participants’ cognitive functions. Multiple linear regression analysis was employed to test the hypothesis that certain factors influence cognitive performance in patients with OSAHS. Results — Scores for the Full-Scale Intelligence Quotient (FSIQ), Visual Spatial Index (VSI), Fluid Reasoning Index (FRI), Working Memory Index (WMI), and Processing Speed Index (PSI) were significantly lower in obese boys with OSAHS. In NW participants with OSAHS, FSIQ and PSI scores were significantly lower than in the control group, but similar in their obese peers on all WISC measures. Regression analysis revealed that neck and waist / hip circumference in nonobese boys, as well as the apnea-hypopnea index, oxygen desaturation index, and sleep fragmentation index in obese boys, are independent negative predictors of cognitive impairment in OSAHS. Conclusion — This pilot study demonstrated that cognitive performance in boys with OSAHS declines, with a predominant deterioration of nonverbal abilities. This trend is most pronounced in obesity, which exacerbates both hypoxia and sleep fragmentation. These results are novel and potentially interesting for further discussions about the impact of OSAHS on cognitive development during middle adolescence, but future research should explore the limitations of the current study.