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Background <p>Sleep-disordered breathing (SDB) in children is increasingly associated with cognitive impairment, though the mechanisms remain unclear. This study explored associations among SDB severity, sleep architecture, metabolic biomarkers, and declarative memory.</p> Methods <p>A total of 117 children who presented with snoring were enrolled in the study. All participants underwent overnight polysomnography. Declarative memory was assessed using a modified paired-associate learning test. Fasting venous blood samples were collected to measure serum levels of leptin, adiponectin, and soluble leptin receptor. The leptin/adiponectin (L/A) ratio and free leptin index (FLI) were also calculated.</p> Results <p>REM-related respiratory disturbance indices (OAHI<sub><i>REM</i></sub>, AHI<sub><i>REM</i></sub>, ODI<sub><i>REM</i></sub>) were significantly negatively correlated with immediate and delayed recognition accuracy (<i>p</i> &lt; 0.05). Higher levels of leptin and FLI were significantly associated with poorer memory performance (<i>p</i> &lt; 0.05), whereas adiponectin levels were lower in children with severe SDB and negatively correlated with multiple respiratory parameters. The L/A ratio and FLI were positively correlated with REM-specific respiratory disturbances and negatively associated with cognitive performance.</p> Conclusion <p>Children with SDB show REM sleep disruption and metabolic dysregulation linked to impaired declarative memory. Leptin resistance may mediate these effects via hippocampal dysfunction. Findings underscore the importance of early detection and metabolic targeting to prevent cognitive deficits in pediatric SDB.</p> Impact <p><UnorderedList Mark="Bullet"> <ItemContent> <p>REM-predominant sleep-disordered breathing is associated with poorer declarative memory performance in children.</p> </ItemContent> <ItemContent> <p>Higher leptin/free leptin index (FLI) is linked to worse memory outcomes in this pediatric cohort.</p> </ItemContent> <ItemContent> <p>We highlight sleep-stage specificity by evaluating REM-related PSG indices (including REM/NREM ratios), beyond global AHI/OAHI measures.</p> </ItemContent> <ItemContent> <p>We integrate PSG phenotyping with metabolic biomarkers (leptin, FLI, adiponectin) to better characterize neurocognitive risk.</p> </ItemContent> <ItemContent> <p>Our findings support improved risk stratification and motivate longitudinal and interventional studies targeting REM-related SDB and metabolic dysfunction to protect cognition.</p> </ItemContent> </UnorderedList></p> <p></p>

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Associations between REM-related respiratory disturbances, metabolic biomarkers, and memory impairment in pediatric sleep-disordered breathing

  • 期刊论文

  • 发表日期：

    2026年5月14日

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  • Kai Zhang,
  • Dandi Ma,
  • Ruobing Song,
  • Yunxiao Wu,
  • Changming Wang,
  • Xin Ni,
  • Zhifei Xu

摘要

Background

Sleep-disordered breathing (SDB) in children is increasingly associated with cognitive impairment, though the mechanisms remain unclear. This study explored associations among SDB severity, sleep architecture, metabolic biomarkers, and declarative memory.

Methods

A total of 117 children who presented with snoring were enrolled in the study. All participants underwent overnight polysomnography. Declarative memory was assessed using a modified paired-associate learning test. Fasting venous blood samples were collected to measure serum levels of leptin, adiponectin, and soluble leptin receptor. The leptin/adiponectin (L/A) ratio and free leptin index (FLI) were also calculated.

Results

REM-related respiratory disturbance indices (OAHIREM, AHIREM, ODIREM) were significantly negatively correlated with immediate and delayed recognition accuracy (p < 0.05). Higher levels of leptin and FLI were significantly associated with poorer memory performance (p < 0.05), whereas adiponectin levels were lower in children with severe SDB and negatively correlated with multiple respiratory parameters. The L/A ratio and FLI were positively correlated with REM-specific respiratory disturbances and negatively associated with cognitive performance.

Conclusion

Children with SDB show REM sleep disruption and metabolic dysregulation linked to impaired declarative memory. Leptin resistance may mediate these effects via hippocampal dysfunction. Findings underscore the importance of early detection and metabolic targeting to prevent cognitive deficits in pediatric SDB.

Impact

REM-predominant sleep-disordered breathing is associated with poorer declarative memory performance in children.

Higher leptin/free leptin index (FLI) is linked to worse memory outcomes in this pediatric cohort.

We highlight sleep-stage specificity by evaluating REM-related PSG indices (including REM/NREM ratios), beyond global AHI/OAHI measures.

We integrate PSG phenotyping with metabolic biomarkers (leptin, FLI, adiponectin) to better characterize neurocognitive risk.

Our findings support improved risk stratification and motivate longitudinal and interventional studies targeting REM-related SDB and metabolic dysfunction to protect cognition.