Related Experiment Videos
Conduct problems and symptoms of sleep disorders in children
Ronald D Chervin1, James E Dillon, Kristen Hedger Archbold
1Sleep Disorders Center and Department of Neurology, University of Michigan, Ann Arbor, USA. chervin@umich.edu
Insights
Conduct problems in children are linked to sleep disorders like sleep-disordered breathing (SDB) and restless legs syndrome (RLS). Early assessment of sleep issues may offer new treatment avenues for aggressive behaviors.
Area of Science:
- Pediatric Sleep Medicine
- Child Psychology
- Behavioral Science
Background:
- Conduct problems and hyperactivity are common in children with diagnosed sleep disorders.
- Limited research exists on these behavioral issues in children not referred to specialized sleep centers.
Purpose of the Study:
- To investigate the prevalence of conduct problems and hyperactivity in children with potential sleep-disordered breathing (SDB), restless legs syndrome (RLS), or periodic leg movements during sleep (PLMS) in a general pediatric clinic setting.
Main Methods:
- Parental surveys were conducted on 872 children (aged 2-14) using validated questionnaires for SDB, PLMS, and the Conners Parent Rating Scale (CPRS-48) to assess conduct problems and hyperactivity.
- Data were collected between 1998 and 2000 at two general clinics.
Main Results:
- Children at high risk for SDB exhibited two to three times more aggressive behaviors, including bullying, compared to other children.
- A significant association was found between high conduct problem scores and SDB (p <.0001), which persisted after adjusting for sleepiness, hyperactivity, stimulant use, or PLMS.
- Similar associations were observed between high conduct problem scores and PLMS.
Conclusions:
- Conduct problems in children are associated with symptoms indicative of SDB, RLS, and PLMS.
- While causality is not proven, identifying sleep disorders could present novel treatment opportunities for aggressive children.
Objective:
Conduct problems and hyperactivity are frequent among children referred for sleep-disordered breathing (SDB), restless legs syndrome, or periodic leg movements during sleep (PLMS), but children not referred to sleep centers have received little study.
Method:
Parents of children aged 2 to 14 years were surveyed at two general clinics between 1998 and 2000. A Pediatric Sleep Questionnaire generated validated scores for SDB and PLMS. The Conners Parent Rating Scale (CPRS-48) produced an age- and sex-adjusted Conduct Problem Index (CPI) and Hyperactivity Index.
Results:
Parents of about 1,400 children were approached; those of 872 (62%) completed the surveys. Bullying and other specific aggressive behaviors were generally two to three times more frequent among 114 children at high risk for SDB than among the remaining children. An association between high CPI and SDB scores (p <.0001) retained significance after adjustment for sleepiness, high Hyperactivity Index, stimulant use, or PLMS scores. Analogous results were obtained for the association between high CPI and PLMS scores.
Conclusions:
Conduct problems were associated with symptoms of SDB, restless legs syndrome, and PLMS. Although these results cannot prove a cause-and-effect relationship, assessment for sleep disorders may provide a new treatment opportunity for some aggressive children.