{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T01:59:18Z","timestamp":1791165558017,"version":"4.1.0"},"reference-count":83,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T00:00:00Z","timestamp":1763683200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Obstructive sleep apnea (OSA) in children is linked to cognitive impairment, which is further aggravated by fragmented sleep, intermittent hypoxia, and comorbid attention deficit hyperactivity disorder (ADHD), often resulting in poor academic performance, behavioral problems, and delayed neurodevelopment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A bibliometric and scientometric analysis was conducted using Web of Science Core Collection (WoSCC) and Scopus databases (1983\u20132025). After exclusion of non-article records and duplicates, 1,610 studies were included. CiteSpace, VOSviewer, and the R-based Bibliometrix package were employed to analyze publication trends, authorship, institutional collaborations, co-citations, and keyword evolution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Since 2010, scholarly attention to pediatric obstructive sleep apnea and its cognitive implications has grown rapidly, with research output increasing at an annual rate of 11.96%. The United States, China, and several European countries stand out as major contributors, both in terms of publications and international collaboration. Prominent academic centers\u2014such as Harvard University, the University of Michigan, and the University of Chicago\u2014serve as key institutional hubs. Among the most influential contributors to the field are David Gozal and Leila Kheirandish-Gozal, while leading journals include\n                      <jats:italic>Sleep Medicine<\/jats:italic>\n                      and\n                      <jats:italic>the Journal of Clinical Sleep Medicine<\/jats:italic>\n                      . Keyword mapping highlights the central focus on \u201cobstructive sleep apnea,\u201d \u201cchildren,\u201d and \u201csleep-disordered breathing,\u201d alongside diagnostic and treatment terms such as \u201cpolysomnography\u201d and \u201cadenotonsillectomy.\u201d Notably, there is growing emphasis on cognitive and behavioral aspects, including \u201ccognition,\u201d \u201cbehavior,\u201d and \u201cADHD,\u201d as well as comorbidities like \u201cobesity\u201d and \u201cDown syndrome.\u201d Recent clusters underscore advances in artificial intelligence (AI) and machine learning (ML) based models using oximetry, electrocardiogram (ECG), and acoustic data, enabling early detection and supporting precision medicine approaches.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The relationship between pediatric obstructive sleep apnea and neurocognitive development has gained significant attention, with recent research focusing on cognitive outcomes and emerging technologies. While conventional treatments remain important, their limited impact on cognitive recovery underscores the need for early diagnosis and personalized therapies. Advances in artificial intelligence and machine learning are improving diagnostic accuracy, enabling earlier interventions, and supporting neurocognitive function in affected children. These developments reflect a shift toward precision-based, tailored care rather than one-size-fits-all treatments.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2025.1704504","type":"journal-article","created":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T05:15:29Z","timestamp":1763702129000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Advancements in pediatric obstructive sleep apnea: cognitive implications and the role of AI in precision medicine"],"prefix":"10.3389","volume":"12","author":[{"given":"Bomeng","family":"Zhao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haixia","family":"Fan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiyan","family":"Niu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shudan","family":"Deng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Zhai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Limantian","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoling","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,21]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"30","DOI":"10.3390\/medsci5040030","article-title":"Cognitive and behavioral consequences of sleep disordered breathing in children","volume":"5","author":"Trosman","year":"2017","journal-title":"Med Sci"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1995","DOI":"10.2147\/nss.S484458","article-title":"Impaired attention in children with obstructive sleep apnea: a preliminary study of behavior combined with neuroelectrophysiology","volume":"16","author":"Wu","year":"2024","journal-title":"Nat Sci Sleep"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1087","DOI":"10.2147\/ndt.S47287","article-title":"Executive dysfunction in children affected by obstructive sleep apnea syndrome: an observational study","volume":"9","author":"Esposito","year":"2013","journal-title":"Neuropsychiatr Dis Treat"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1447","DOI":"10.1093\/sleep\/33.11.1447","article-title":"The association between sleep disordered breathing, academic grades, and cognitive and behavioral functioning among overweight subjects during middle to late childhood","volume":"33","author":"Beebe","year":"2010","journal-title":"Sleep"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1337","DOI":"10.5664\/jcsm.10532","article-title":"Application of artificial intelligence in the diagnosis of sleep apnea","volume":"19","author":"Bazoukis","year":"2023","journal-title":"J Clin Sleep Med"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"2906","DOI":"10.1109\/jbhi.2020.3048901","article-title":"A convolutional neural network architecture to enhance oximetry ability to diagnose pediatric obstructive sleep apnea","volume":"25","author":"Vaquerizo-Villar","year":"2021","journal-title":"IEEE J Biomed Health Inform"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"649","DOI":"10.1007\/s11325-021-02425-w","article-title":"Utilisation of machine learning to predict surgical candidates for the treatment of childhood upper airway obstruction","volume":"26","author":"Liu","year":"2022","journal-title":"Sleep Breath"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1503","DOI":"10.5664\/jcsm.11746","article-title":"Perspective: precision medicine in Osa: the future of a past and present riddle","volume":"21","author":"Labarca","year":"2025","journal-title":"J Clin Sleep Med"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1259251","DOI":"10.3389\/fpsyt.2023.1259251","article-title":"Obstructive sleep apnea and cognition: insights gleaned from bibliomet ric analysis","volume":"14","author":"Dong","year":"2023","journal-title":"Front Psych"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"981379","DOI":"10.3389\/fpsyg.2022.981379","article-title":"Metabolic syndrome and cognition: a systematic review across cognitive domains and a bibliometric analysis","volume":"13","author":"Koutsonida","year":"2022","journal-title":"Front Psychol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1002\/asi.20317","article-title":"Citespace ii: detecting and visualizing emerging trends and transient patterns in scientific literature","volume":"57","author":"Chen","year":"2006","journal-title":"J Am Soc Inf Sci"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1515\/jdis-2017-0006","article-title":"Science mapping: a systematic review of the literature","volume":"2","author":"Chen","year":"2017","journal-title":"J Data Inf Sci"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1007\/s11192-009-0146-3","article-title":"Software survey: Vosviewer, a computer program for bibliometric mappin g","volume":"84","author":"van Eck","year":"2010","journal-title":"Scientometrics"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1007\/s11192-006-0144-7","article-title":"Theory and Practise of the G-index","volume":"69","author":"Egghe","year":"2006","journal-title":"Scientometrics"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"16569","DOI":"10.1073\/pnas.0507655102","article-title":"An index to quantify an individual's scientific research output","volume":"102","author":"Hirsch","year":"2005","journal-title":"Proc Natl Acad Sci USA"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"959","DOI":"10.1016\/j.joi.2017.08.007","article-title":"Bibliometrix: an R-tool for comprehensive science mapping analysis","volume":"11","author":"Aria","year":"2017","journal-title":"J Informetr"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"1947","DOI":"10.5665\/sleep.3236","article-title":"A pro-inflammatory role for nuclear factor kappa B in childhood obstructive sleep apnea syndrome","volume":"36","author":"Israel","year":"2013","journal-title":"Sleep"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"971","DOI":"10.1378\/chest.12-2026","article-title":"Endothelial dysfunction in children with obstructive sleep apnea is associated with epigenetic changes in the Enos gene","volume":"143","author":"Kheirandish-Gozal","year":"2013","journal-title":"Chest"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1186\/s12887-023-04511-2","article-title":"Sleep disordered breathing and neurobehavioral deficits in children and adolescents: a systematic review and meta-analysis","volume":"24","author":"Zhang","year":"2024","journal-title":"BMC Pediatr"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1016\/j.smrv.2013.12.003","article-title":"Attention deficit hyperactivity disorder and sleep disordered breathing in pediatric populations: a meta-analysis","volume":"18","author":"Sedky","year":"2014","journal-title":"Sleep Med Rev"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"521","DOI":"10.1016\/j.smrv.2014.03.006","article-title":"A Meta-analysis and model of the relationship between sleep and depression in adolescents: recommendations for future research and clinical practice","volume":"18","author":"Lovato","year":"2014","journal-title":"Sleep Med Rev"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1016\/j.ijporl.2015.12.014","article-title":"Sleep problems and obstructive sleep apnea in children with down syndrome, an overwiew","volume":"82","author":"Maris","year":"2016","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"2366","DOI":"10.1056\/NEJMoa1215881","article-title":"A randomized trial of adenotonsillectomy for childhood sleep apnea","volume":"368","author":"Marcus","year":"2013","journal-title":"N Engl J Med"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"739","DOI":"10.1164\/rccm.201510-2099OC","article-title":"Effect of sleep-disordered breathing severity on cognitive performance measures in a large community cohort of Young school-aged children","volume":"194","author":"Hunter","year":"2016","journal-title":"Am J Respir Crit Care Med"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"zsac035","DOI":"10.1093\/sleep\/zsac035","article-title":"Neurobehavioral Morbidity of pediatric mild sleep-disordered breathing and obstructive sleep apnea","volume":"45","author":"Yu","year":"2022","journal-title":"Sleep"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1183\/13993003.00385-2015","article-title":"Obstructive sleep disordered breathing in 2- to 18-year-old children: diagnosis and management","volume":"47","author":"Kaditis","year":"2016","journal-title":"Eur Respir J"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"665","DOI":"10.5664\/jcsm.6576","article-title":"Aasm scoring manual updates for 2017 (version 2.4)","volume":"13","author":"Berry","year":"2017","journal-title":"J Clin Sleep Med"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"e20191450","DOI":"10.1542\/peds.2019-1450","article-title":"Cognition after early tonsillectomy for mild Osa","volume":"145","author":"Waters","year":"2020","journal-title":"Pediatrics"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"384","DOI":"10.1016\/j.chest.2019.09.018","article-title":"Allergic Rhinitis and Osa in children residing at a high altitude","volume":"157","author":"Giraldo-Cadavid","year":"2020","journal-title":"Chest"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"120119","DOI":"10.1016\/j.jad.2025.120119","article-title":"Sleep and fatigue complaints during pregnancy versus perinatal depression: impact on toddler cognition","volume":"392","author":"Lunsford-Avery","year":"2025","journal-title":"J Affect Disord"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1007\/s11682-025-01045-2","article-title":"Cerebral network topology and peak width of skeletonized mean diffusivity changes associated with cognitive impairment in patients with obstructive sleep apnea","author":"Lin","year":"2025","journal-title":"Brain Imaging Behav"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"e70553","DOI":"10.1111\/cns.70553","article-title":"Effects of obstructive sleep apnea on cognition: an analysis of electroencephalography microstates and alpha peak frequency","volume":"31","author":"Wang","year":"2025","journal-title":"CNS Neurosci Ther"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"1603","DOI":"10.2147\/nss.S524831","article-title":"Association between fractional exhaled nitric oxide (Feno) and cognitive function in patients with obstructive sleep apnea","volume":"17","author":"Zhu","year":"2025","journal-title":"Nat Sci Sleep"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"e70136","DOI":"10.1111\/jsr.70136","article-title":"Hypoxic load and average oxygen-saturation during sleep and wake are associated with cognitive function in obstructive sleep apnea","author":"Thorisdottir","year":"2025","journal-title":"J Sleep Res"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"100913","DOI":"10.1016\/j.resplu.2025.100913","article-title":"Sleep disorders after cardiac arrest: prevalence and relation with cognitive function","volume":"22","author":"Glimmerveen","year":"2025","journal-title":"Resusc Plus"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"e301","DOI":"10.1371\/journal.pmed.0030301","article-title":"Childhood obstructive sleep apnea associates with neuropsychological deficits and neuronal brain injury","volume":"3","author":"Halbower","year":"2006","journal-title":"PLoS Med"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"962","DOI":"10.1017\/s135561770410708x","article-title":"Neuropsychological effects of pediatric obstructive sleep apnea","volume":"10","author":"Beebe","year":"2004","journal-title":"J Int Neuropsychol Soc"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"790","DOI":"10.1186\/s12888-025-07244-x","article-title":"Relationship between sleep apnea severity and mild cognitive impairment in people with obstructive sleep apnea","volume":"25","author":"Guo","year":"2025","journal-title":"BMC Psychiatry"},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/zpaf044","article-title":"Preliminary investigation of obstructive sleep apnea and Alzheimer's disease in down syndrome","author":"Yoon","year":"2025","journal-title":"Sleep"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"111369","DOI":"10.1016\/j.pnpbp.2025.111369","article-title":"Exploring the shared genetic basis of attention-deficit\/hyperactivity disorder and obstructive sleep apnea: a multi-omics analysis","volume":"139","author":"Huang","year":"2025","journal-title":"Prog Neuro-Psychopharmacol Biol Psychiatry"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"423","DOI":"10.1007\/s41030-025-00299-x","article-title":"Obstructive sleep apnea and sleep disorders in children with attention deficit hyperactivity disorder","volume":"11","author":"Nguyen-Thi-Phuong","year":"2025","journal-title":"Pulm Ther"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"678","DOI":"10.3390\/life15040678","article-title":"The role of polysomnography for children with attention-deficit\/hyperactivity disorder","volume":"15","author":"Lin","year":"2025","journal-title":"Life"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1007\/s41030-024-00286-8","article-title":"Prevalence of obstructive sleep apnea in Vietnamese children with attention deficit hyperactivity disorder (ADHD)","volume":"11","author":"Nguyen-Thi-Phuong","year":"2025","journal-title":"Pulm Ther"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"106661","DOI":"10.1016\/j.sleep.2025.106661","article-title":"Changes in attention deficit and adipokine levels in children with sleep-disordered breathing","volume":"134","author":"Luo","year":"2025","journal-title":"Sleep Med"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"454","DOI":"10.1186\/s12888-025-06899-w","article-title":"The genetic overlap and causal relationship between attention deficit hyperactivity disorder and obstructive sleep apnea: a large-scale genomewide cross-trait analysis","volume":"25","author":"Tong","year":"2025","journal-title":"BMC Psychiatry"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"e103315","DOI":"10.1136\/bmjopen-2025-103315","article-title":"Randomised trial of home sleep Apnoea testing compared to in-lab polysomnography for the evaluation of obstructive sleep Apnoea in children: rationale and study protocol","volume":"15","author":"Roman Rosado","year":"2025","journal-title":"BMJ Open"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"820939","DOI":"10.3389\/fendo.2022.820939","article-title":"Effects of chronic intermittent hypoxia and chronic sleep fragmentation on gut microbiome, serum metabolome, liver and adipose tissue morphology","volume":"13","author":"Wang","year":"2022","journal-title":"Front Endocrinol"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"zsad170","DOI":"10.1093\/sleep\/zsad170","article-title":"Alteration of sleep architecture in children with obstructive sleep apnea syndrome","volume":"46","author":"Bokov","year":"2023","journal-title":"Sleep"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"1050","DOI":"10.1016\/j.neuron.2023.03.005","article-title":"Sleep-a brain-state serving systems memory consolidation","volume":"111","author":"Brodt","year":"2023","journal-title":"Neuron"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"105714","DOI":"10.1016\/j.neubiorev.2024.105714","article-title":"The effect of rem-sleep disruption on affective processing: a systematic review of human and animal experimental studies","volume":"162","author":"Pesonen","year":"2024","journal-title":"Neurosci Biobehav Rev"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"zsae061","DOI":"10.1093\/sleep\/zsae061","article-title":"Sleep-slow oscillation-spindle coupling precedes spindle-ripple coupling during development","volume":"47","author":"Fechner","year":"2024","journal-title":"Sleep"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"bvac146","DOI":"10.1210\/jendso\/bvac146","article-title":"Acute Sleep Disruption Does Not Diminish Pulsatile Growth Hormone Secretion in pubertal children","volume":"6","author":"Calvert","year":"2022","journal-title":"J Endocr Soc"},{"key":"ref53","doi-asserted-by":"publisher","first-page":"44566","DOI":"10.1038\/srep44566","article-title":"Reduced regional grey matter volumes in pediatric obstructive sleep apnea","volume":"7","author":"Philby","year":"2017","journal-title":"Sci Rep"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"1051","DOI":"10.1007\/s11325-024-03001-8","article-title":"Obstructive sleep apnea affects cognition: dual effects of intermittent hypoxia on neurons","volume":"28","author":"He","year":"2024","journal-title":"Sleep Breath"},{"key":"ref55","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1186\/s13062-023-00387-5","article-title":"Microglial Exosomes Alleviate Intermittent Hypoxia-Induced Cognitive Deficits by suppressing Nlrp3 Inflammasome","volume":"18","author":"Zhang","year":"2023","journal-title":"Biol Direct"},{"key":"ref56","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1038\/aps.2011.184","article-title":"Chronic intermittent hypoxia-induced deficits in synaptic plasticity and neurocognitive functions: a role for brain-derived neurotrophic factor","volume":"33","author":"Xie","year":"2012","journal-title":"Acta Pharmacol Sin"},{"key":"ref57","doi-asserted-by":"publisher","first-page":"7","DOI":"10.3389\/fneur.2012.00007","article-title":"Sympathetic and catecholaminergic alterations in sleep apnea with particular emphasis on children","volume":"3","author":"Hakim","year":"2012","journal-title":"Front Neurol"},{"key":"ref58","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1016\/j.sleep.2022.01.005","article-title":"Association between cognitive dysfunction and nocturnal peaks of blood pressure estimated from pulse transit time in obstructive sleep apnoea","volume":"90","author":"Alomri","year":"2022","journal-title":"Sleep Med"},{"key":"ref59","doi-asserted-by":"publisher","first-page":"zsx208","DOI":"10.1093\/sleep\/zsx208","article-title":"Cortical autonomic network gray matter and sympathetic nerve activity in obstructive sleep apnea","volume":"41","author":"Taylor","year":"2018","journal-title":"Sleep"},{"key":"ref60","doi-asserted-by":"publisher","first-page":"1213971","DOI":"10.3389\/fnins.2023.1213971","article-title":"Influence of glutamatergic and gabaergic neurotransmission on obstructive sleep apnea","volume":"17","author":"Kaczmarski","year":"2023","journal-title":"Front Neurosci"},{"key":"ref61","doi-asserted-by":"publisher","first-page":"e1013097","DOI":"10.1371\/journal.pcbi.1013097","article-title":"Cholinergic Modulation of neural networks supports sequential and complementary roles for Nrem and rem states in memory consolidation","volume":"21","author":"Satchell","year":"2025","journal-title":"PLoS Comput Biol"},{"key":"ref62","doi-asserted-by":"publisher","first-page":"109074","DOI":"10.1016\/j.celrep.2021.109074","article-title":"Dysregulation of the Mesoprefrontal dopamine circuit mediates an early-life stress-induced synaptic imbalance in the prefrontal cortex","volume":"35","author":"Oh","year":"2021","journal-title":"Cell Rep"},{"key":"ref63","doi-asserted-by":"publisher","first-page":"729201","DOI":"10.3389\/fphys.2021.729201","article-title":"Nitric oxide pathways in neurovascular coupling under normal and stress conditions in the brain: strategies to rescue aberrant coupling and improve cerebral blood flow","volume":"12","author":"Louren\u00e7o","year":"2021","journal-title":"Front Physiol"},{"key":"ref64","doi-asserted-by":"publisher","first-page":"2125","DOI":"10.2147\/nss.S329408","article-title":"The impacts of obstructive sleep apnea severity on brain white matter integrity and cognitive functions in children: a diffusion tensor imaging study","volume":"13","author":"Mei","year":"2021","journal-title":"Nat Sci Sleep"},{"key":"ref65","doi-asserted-by":"publisher","first-page":"4","DOI":"10.3389\/fneur.2018.00004","article-title":"Altered regional brain cortical thickness in pediatric obstructive sleep apnea","volume":"9","author":"Macey","year":"2018","journal-title":"Front Neurol"},{"key":"ref66","doi-asserted-by":"publisher","first-page":"zsac201","DOI":"10.1093\/sleep\/zsac201","article-title":"Cortical thickness and hippocampal volume in adolescent children with obstructive sleep apnea","volume":"46","author":"Lee","year":"2023","journal-title":"Sleep"},{"key":"ref67","doi-asserted-by":"publisher","first-page":"1420","DOI":"10.1038\/s41372-023-01748-8","article-title":"Developmental consequences of short apneas and periodic breathing in preterm infants","volume":"43","author":"Yee","year":"2023","journal-title":"J Perinatol"},{"key":"ref68","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1007\/s40140-019-00331-2","article-title":"Pediatric obstructive sleep apnea: neurocognitive consequences","volume":"9","author":"Chandrakantan","year":"2019","journal-title":"Curr Anesthesiol Rep"},{"key":"ref69","doi-asserted-by":"publisher","first-page":"101343","DOI":"10.1016\/j.arr.2021.101343","article-title":"Hypoxia and brain aging: neurodegeneration or neuroprotection?","volume":"68","author":"Burtscher","year":"2021","journal-title":"Ageing Res Rev"},{"key":"ref70","doi-asserted-by":"publisher","first-page":"59","DOI":"10.3389\/fncel.2015.00059","article-title":"Control of the neurovascular coupling by nitric oxide-dependent regulation of astrocytic ca(2+) signaling","volume":"9","author":"Mu\u00f1oz","year":"2015","journal-title":"Front Cell Neurosci"},{"key":"ref71","doi-asserted-by":"publisher","first-page":"1537","DOI":"10.5665\/sleep.5042","article-title":"Chronic intermittent hypoxia induces chronic low-grade neuroinflammation in the dorsal hippocampus of mice","volume":"38","author":"Sapin","year":"2015","journal-title":"Sleep"},{"key":"ref72","doi-asserted-by":"publisher","first-page":"1502906","DOI":"10.3389\/fneur.2025.1502906","article-title":"Relationship between cognitive dysfunction and urinary 8-Ohdg levels in children with obstructive sleep apnea","volume":"16","author":"Chen","year":"2025","journal-title":"Front Neurol"},{"key":"ref73","doi-asserted-by":"publisher","first-page":"2084","DOI":"10.1001\/jama.2023.22114","article-title":"Adenotonsillectomy for snoring and mild sleep apnea in children: a randomized clinical trial","volume":"330","author":"Redline","year":"2023","journal-title":"JAMA"},{"key":"ref74","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1186\/s12887-022-03111-w","article-title":"Effect of adenotonsillectomy on the growth, development, and comprehen sive cognitive abilities of children with obstructive sleep apnea: a p rospective single-arm study","volume":"22","author":"Shan","year":"2022","journal-title":"BMC Pediatr"},{"key":"ref75","doi-asserted-by":"publisher","first-page":"998","DOI":"10.1164\/rccm.201112-2167OC","article-title":"Effects of positive airway pressure therapy on neurobehavioral outcomes in children with obstructive sleep apnea","volume":"185","author":"Marcus","year":"2012","journal-title":"Am J Respir Crit Care Med"},{"key":"ref76","doi-asserted-by":"publisher","first-page":"973","DOI":"10.1007\/s11325-022-02687-y","article-title":"Efficacy of CPAP duration and adherence for cognitive improvement in P atients with obstructive sleep apnea: a meta-analysis of randomized co ntrolled trials","volume":"27","author":"Li","year":"2022","journal-title":"Sleep Breath"},{"key":"ref77","doi-asserted-by":"publisher","first-page":"1736","DOI":"10.1513\/AnnalsATS.201606-432OC","article-title":"Montelukast for children with obstructive sleep apnea: results of a double-blind, randomized, placebo-controlled trial","volume":"13","author":"Kheirandish-Gozal","year":"2016","journal-title":"Ann Am Thorac Soc"},{"key":"ref78","doi-asserted-by":"publisher","first-page":"1328209","DOI":"10.3389\/fped.2024.1328209","article-title":"Pediatric obstructive sleep apnea diagnosis: leveraging machine learni ng with linear discriminant analysis","volume":"12","author":"Qin","year":"2024","journal-title":"Front Pediatr"},{"key":"ref79","doi-asserted-by":"publisher","first-page":"278","DOI":"10.1186\/s12911-025-03129-x","article-title":"Diagnostic accuracy of artificial intelligence for obstructive sleep a pnea detection: a systematic review","volume":"25","author":"Haghighat","year":"2025","journal-title":"BMC Med Inform Decis Mak"},{"key":"ref80","doi-asserted-by":"publisher","first-page":"zsab047","DOI":"10.1093\/sleep\/zsab047","article-title":"Brain function in children with obstructive sleep apnea: a resting-sta te fmri study","volume":"44","author":"Ji","year":"2024","journal-title":"Sleep"},{"key":"ref81","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1007\/s11682-023-00809-y","article-title":"Diffusion kurtosis imaging tractography reveals disrupted white matter structural networks in children with obstructive sleep apnea syndrome","volume":"18","author":"Li","year":"2024","journal-title":"Brain Imaging Behav"},{"key":"ref82","doi-asserted-by":"publisher","first-page":"900","DOI":"10.1001\/jamaoto.2020.2432","article-title":"Predictors of behavioral changes after adenotonsillectomy in pediatric obstructive sleep apnea","volume":"146","author":"Isaiah","year":"2020","journal-title":"JAMA Otolaryngol Head Neck Surg"},{"key":"ref83","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1186\/s13052-022-01364-w","article-title":"Increased behavioral problems in children with sleep-disordered breath ing","volume":"48","author":"Cs\u00e1bi","year":"2022","journal-title":"Ital J Pediatr"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1704504\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T05:15:30Z","timestamp":1763702130000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1704504\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,21]]},"references-count":83,"alternative-id":["10.3389\/fmed.2025.1704504"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2025.1704504","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,21]]},"article-number":"1704504"}}