Related Experiment Videos
Inattention, hyperactivity, and symptoms of sleep-disordered breathing
Ronald D Chervin1, Kristen Hedger Archbold, James E Dillon
1Sleep Disorders Center, Department of Neurology, University of Michigan, Ann Arbor, Michigan. chervin@umich.edu
Insights
Inattentive and hyperactive children often show symptoms of sleep-disordered breathing (SDB), particularly young boys. Addressing SDB may improve behavior and reduce public health impact.
Area of Science:
- Pediatric Sleep Medicine
- Child Behavioral Health
Background:
- Inattention and hyperactivity are common in children and can be exacerbated by sleep issues.
- Sleep-disordered breathing (SDB) is frequently observed in children and linked to behavioral problems.
Purpose of the Study:
- To investigate the prevalence of SDB symptoms in children presenting with inattention and hyperactivity.
- To explore the association between SDB symptoms and behavioral issues in a general pediatric population.
Main Methods:
- A cross-sectional survey was conducted in two general pediatric clinics.
- 866 children (aged 2-13.9 years) completed validated questionnaires assessing snoring, sleepiness, and SDB risk.
- Parental reports on inattention/hyperactivity using the IHS and Conners' HI scales were collected.
Main Results:
- 16% of children reported habitual snoring.
- High hyperactivity scores (HI >60) were found in 13% of participants, with a 2.2 odds ratio associated with habitual snoring.
- Associations between hyperactivity and snoring/SDB symptoms were stronger in boys under 8 years old.
Conclusions:
- Inattention and hyperactivity in pediatric patients are linked to increased daytime sleepiness and SDB symptoms, especially in young boys.
- The findings suggest a significant public health impact if SDB influences daytime behavior in children.
Objective:
Inattention and hyperactivity are frequent among children with sleep-disordered breathing (SDB) and often improve when SDB is treated. However, the frequency of SDB symptoms among inattentive and hyperactive children has received little study.
Design:
Cross-sectional survey.
Setting:
Two university-affiliated but community-based general pediatrics clinics.
Patients:
Patients consisted of N = 866 children (469 boys), aged 2.0 to 13.9 years (mean: 6.8 plus minus 3.2 years), with clinic appointments.
Measures:
A validated Pediatric Sleep Questionnaire assessed for habitual snoring (1 item), snoring severity (a 4-item subscale), sleepiness (4 items), and overall risk of SDB (16 items). Parents also completed 2 common behavioral measures, an inattention/hyperactivity scale (IHS) derived from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and the hyperactivity index (HI, expressed as a t score) of the Conners' Parent Rating Scale.
Results:
Habitual snoring was reported in 16% (95% confidence interval [CI]: 13, 19) of the participants. High HI scores (>60) were found in 13% (95% CI: 11, 16) of all participants, 22% (95% CI: 15, 29) of habitual snorers, and 12% (95% CI: 9, 14) of nonsnorers. Odds ratios between HI >60 and each of the following were: habitual snoring, 2.2 (95% CI: 1.4, 3.6); 1 additional positive symptom-item on the snoring scale, 1.3 (95% CI: 1.1, 1.5); 1 additional positive item on the sleepiness scale, 1.6 (95% CI: 1.4, 2.0); and a 1-standard deviation increase in the overall SDB score, 1.7 (95% CI: 1.4, 2.0; all odds ratios age- and sex-adjusted). Results were similar for high IHS scores (>1.25). Stratification by age and sex showed that most of the association with snoring (but not sleepiness) derived from boys <8 years old.
Conclusions:
Inattention and hyperactivity among general pediatric patients are associated with increased daytime sleepiness and---especially in young boys---snoring and other symptoms of SDB. If sleepiness and SDB do influence daytime behavior, the current results suggest a major public health impact.