Advances in gut microbiota research among pediatric patients with sleep-disordered breathing.

Sleep-disordered breathing (SDB) in children encompasses a spectrum of disorders characterized by abnormal breathing during sleep, with obstructive sleep apnea (OSA) being the most prevalent phenotype. Traditionally, SDB has been viewed as a disorder involving local upper airway structural and neuromodulatory abnormalities. In recent years, the role of the gut microbiota as the "second brain" 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-particularly those governing gut microbiota-mediated cognitive and behavioral alterations-and 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.