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In recent years, the role of the gut microbiota as the \u201csecond brain\u201d and a systemic regulator of immunity and metabolism has gained increasing prominence. Accumulating evidence suggests a bidirectional association between pediatric SDB and gut microbiota dysbiosis. This review summarizes recent advances in research on the interplay between pediatric SDB and the gut microbiota, explores the underlying mechanisms\u2014particularly those governing gut microbiota-mediated cognitive and behavioral alterations\u2014and discusses potential diagnostic biomarkers and novel adjunctive therapeutic strategies targeting the gut microbiota. It aims to provide new perspectives for the comprehensive management of pediatric SDB.<\/jats:p>","DOI":"10.3389\/fmicb.2026.1871503","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T15:39:29Z","timestamp":1786030769000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Advances in gut microbiota research among pediatric patients with sleep-disordered breathing"],"prefix":"10.3389","volume":"17","author":[{"given":"Huijie","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Shandong Medical and Pharmaceutical University Hospital","place":["Binzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haochen","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Shandong Medical and Pharmaceutical University Hospital","place":["Binzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kailu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Shandong Medical and Pharmaceutical University Hospital","place":["Binzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rongfei","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Shandong Medical and Pharmaceutical University Hospital","place":["Binzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Shandong Medical and Pharmaceutical University Hospital","place":["Binzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Shandong Medical and Pharmaceutical University Hospital","place":["Binzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e029218","DOI":"10.1161\/JAHA.122.029218","article-title":"Obstructive sleep apnea-induced hypertension is associated with increased gut and neuroinflammation","volume":"12","author":"Ayyaswamy","year":"2023","journal-title":"J. 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