Washington, April 10 : Researchers at Hasbro Children's Hospital have shed light on the association between childhood sleep-disordered breathing (SDB), including snoring and sleep apnea, and behavioural problems like hyperactivity and anxiety.
The study, led by Judith A. Owens, M.D., M.P.H., director of the paediatric sleep disorders clinic at Hasbro Children's Hospital, found that kids with SDB who are also overweight, sleep for short periods of time, or have another sleep disorder like insomnia are more likely to have behaviour issues.
"It's important for clinicians to consider the contributions of these risk factors when screening, triaging, evaluating and designing treatments for children with SDB, particularly since they can help identify those patients who are in need of aggressive interventions and close follow-up," Owens said.
In the study, Owens and colleagues analyzed the charts of more than 230 kids and adolescents between the ages of 3 and 18 years with SDB symptoms who were referred for sleep testing.
The researchers relied on each participant's history of behavioural, emotional and academic problems as well as Child Behaviour Checklist (CBCL) scores, a devise used to measure child behaviour problems based on parents' observations.
The study participants were also divided into three weight groups based on sex and age-adjusted norms for body mass index.
Researchers found that more than half of the study sample was overweight or at risk for overweight, and at least one-third were short sleepers.
Almost 50 percent of all kids had at least one additional sleep diagnosis. esearchers found that 47 percent had a history of behavioural problems and 23 percent had a reported diagnosis of attention deficit hyperactivity disorder (ADHD).
Rather surprisingly, it was found that the strongest predictor of adverse behavioural outcomes and CBCL scores was the presence of at least one additional sleep diagnosis, especially insomnia - not the measure of SDB disease severity, which researchers thought would play a more significant role.
But the authors note that the lack of link between SDB severity and behavioural outcomes does not mean that SDB doesn't adversely affect kids' behaviour. Our results may be interpreted as suggesting that, within the spectrum of patients in this study, severity may have a relatively weaker influence on behavioural outcomes," Owens said.
The weight group also appeared to be closely associated with poor behavioural outcomes, with the most consistent differences between the overweight and average weight groups.
And as researchers thought, shorter mean sleep duration was linked to worse behavioural outcomes, particularly externalising concerns.
The study is published in the April issue of the Archives of Paediatric and Adolescent Medicine.