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Inattention, hyperactivity, and symptoms of sleep-disordered breathing.
Pediatrics. 2002 Mar; 109(3):449-56.Ped

Abstract

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.

Authors+Show Affiliations

Sleep Disorders Center, Department of Neurology, University of Michigan, Ann Arbor, Michigan. chervin@umich.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

11875140

Citation

Chervin, Ronald D., et al. "Inattention, Hyperactivity, and Symptoms of Sleep-disordered Breathing." Pediatrics, vol. 109, no. 3, 2002, pp. 449-56.
Chervin RD, Archbold KH, Dillon JE, et al. Inattention, hyperactivity, and symptoms of sleep-disordered breathing. Pediatrics. 2002;109(3):449-56.
Chervin, R. D., Archbold, K. H., Dillon, J. E., Panahi, P., Pituch, K. J., Dahl, R. E., & Guilleminault, C. (2002). Inattention, hyperactivity, and symptoms of sleep-disordered breathing. Pediatrics, 109(3), 449-56.
Chervin RD, et al. Inattention, Hyperactivity, and Symptoms of Sleep-disordered Breathing. Pediatrics. 2002;109(3):449-56. PubMed PMID: 11875140.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Inattention, hyperactivity, and symptoms of sleep-disordered breathing. AU - Chervin,Ronald D, AU - Archbold,Kristen Hedger, AU - Dillon,James E, AU - Panahi,Parviz, AU - Pituch,Kenneth J, AU - Dahl,Ronald E, AU - Guilleminault,Christian, PY - 2002/3/5/pubmed PY - 2002/4/17/medline PY - 2002/3/5/entrez SP - 449 EP - 56 JF - Pediatrics JO - Pediatrics VL - 109 IS - 3 N2 - 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. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/11875140/Inattention_hyperactivity_and_symptoms_of_sleep_disordered_breathing_ L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&amp;pmid=11875140 DB - PRIME DP - Unbound Medicine ER -