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Symptoms of inattention and hyperactivity in children with habitual snoring: evidence from a community-based study in Istanbul.
Child Care Health Dev 2005; 31(6):707-17CC

Abstract

BACKGROUND

Neurobehavioural symptoms of inattention and hyperactivity are common in children with sleep-disordered breathing (SDB). Prevalence rates of habitual snoring and attention deficit hyperactivity disorder (ADHD) are very similar and both have a substantial negative effect on children's behavioural health.

OBJECTIVE

We examined the differences for subjective attentional and hyperactivity measures reported by parents and teachers among primary school children with habitual snoring and age- and sex-matched controls in a community-based case-control study in Istanbul. Methods In 2002, a survey was carried out to determine the prevalence of snoring in 2147 primary school children. After one year, in 2003, 151 children with habitual snoring and 302 controls from this survey were studied with parental SDB questionnaire, Conners' Parent (Conners-P) and Teacher Scales, and an inattention hyperactivity scale (IHS). Exclusion criteria included history of ADHD diagnosis, controls who started to snore and habitual snorers (HS) who no longer snored in this follow-up study.

RESULTS

Ninety-six HS and 190 control subjects (mean age: 9.4 +/- 1.3) were evaluated. HS had significantly more symptoms of hyperactivity (Conners-ADHD index) (P: 0.033), attentional (P: 0.019), and conduct and oppositional defiant in subscales (P: 0.001) of Conners-P and IHS-Parents. A pooled score of Conners-P ADHD Index > 60 and IHS-Parent score > 1.25 showed considerable difference in HS when compared with controls (5.1% vs. 1.4%) (P < 0.0001). Daytime hyperactivity and excessive daytime sleepiness reported by parents correlated with scores of Conners-P and IHS-P (P < 0.01). Teachers' observations showed significant correlations with learning disability and the level of academic performance in HS (P < 0.01). Other behavioural parameters related to SDB were not significantly correlated with teachers' ADHD ratings in HS.

CONCLUSION

Increased rates of moderate hyperactivity as well as conduct and oppositional defiant symptoms in HS reported by the parents might reflect a negative impact on overall neurobehavioural health. The teachers' scores yielded no significant results among HS and controls. This may be caused by the limitation due to shared method variance. The negative effect of crowded classes on teachers' evaluations must be also taken into consideration. After exclusion of a diagnosis of ADHD in children presenting with hyperactivity and inattention, children with habitual snoring with prominent scores of behavioural measures should be considered as candidates for further assessment by a sleep specialist.

Authors+Show Affiliations

Marmara University Child Psychiatry Department, Marmara University, Altunizade, Istanbul, Turkey. aarman@marmara.edu.trNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16207229

Citation

Arman, A R., et al. "Symptoms of Inattention and Hyperactivity in Children With Habitual Snoring: Evidence From a Community-based Study in Istanbul." Child: Care, Health and Development, vol. 31, no. 6, 2005, pp. 707-17.
Arman AR, Ersu R, Save D, et al. Symptoms of inattention and hyperactivity in children with habitual snoring: evidence from a community-based study in Istanbul. Child Care Health Dev. 2005;31(6):707-17.
Arman, A. R., Ersu, R., Save, D., Karadag, B., Karaman, G., Karabekiroglu, K., ... Berkem, M. (2005). Symptoms of inattention and hyperactivity in children with habitual snoring: evidence from a community-based study in Istanbul. Child: Care, Health and Development, 31(6), pp. 707-17.
Arman AR, et al. Symptoms of Inattention and Hyperactivity in Children With Habitual Snoring: Evidence From a Community-based Study in Istanbul. Child Care Health Dev. 2005;31(6):707-17. PubMed PMID: 16207229.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Symptoms of inattention and hyperactivity in children with habitual snoring: evidence from a community-based study in Istanbul. AU - Arman,A R, AU - Ersu,R, AU - Save,D, AU - Karadag,B, AU - Karaman,G, AU - Karabekiroglu,K, AU - Karakoc,F, AU - Dagli,E, AU - Berkem,M, PY - 2005/10/7/pubmed PY - 2006/2/1/medline PY - 2005/10/7/entrez SP - 707 EP - 17 JF - Child: care, health and development JO - Child Care Health Dev VL - 31 IS - 6 N2 - BACKGROUND: Neurobehavioural symptoms of inattention and hyperactivity are common in children with sleep-disordered breathing (SDB). Prevalence rates of habitual snoring and attention deficit hyperactivity disorder (ADHD) are very similar and both have a substantial negative effect on children's behavioural health. OBJECTIVE: We examined the differences for subjective attentional and hyperactivity measures reported by parents and teachers among primary school children with habitual snoring and age- and sex-matched controls in a community-based case-control study in Istanbul. Methods In 2002, a survey was carried out to determine the prevalence of snoring in 2147 primary school children. After one year, in 2003, 151 children with habitual snoring and 302 controls from this survey were studied with parental SDB questionnaire, Conners' Parent (Conners-P) and Teacher Scales, and an inattention hyperactivity scale (IHS). Exclusion criteria included history of ADHD diagnosis, controls who started to snore and habitual snorers (HS) who no longer snored in this follow-up study. RESULTS: Ninety-six HS and 190 control subjects (mean age: 9.4 +/- 1.3) were evaluated. HS had significantly more symptoms of hyperactivity (Conners-ADHD index) (P: 0.033), attentional (P: 0.019), and conduct and oppositional defiant in subscales (P: 0.001) of Conners-P and IHS-Parents. A pooled score of Conners-P ADHD Index > 60 and IHS-Parent score > 1.25 showed considerable difference in HS when compared with controls (5.1% vs. 1.4%) (P < 0.0001). Daytime hyperactivity and excessive daytime sleepiness reported by parents correlated with scores of Conners-P and IHS-P (P < 0.01). Teachers' observations showed significant correlations with learning disability and the level of academic performance in HS (P < 0.01). Other behavioural parameters related to SDB were not significantly correlated with teachers' ADHD ratings in HS. CONCLUSION: Increased rates of moderate hyperactivity as well as conduct and oppositional defiant symptoms in HS reported by the parents might reflect a negative impact on overall neurobehavioural health. The teachers' scores yielded no significant results among HS and controls. This may be caused by the limitation due to shared method variance. The negative effect of crowded classes on teachers' evaluations must be also taken into consideration. After exclusion of a diagnosis of ADHD in children presenting with hyperactivity and inattention, children with habitual snoring with prominent scores of behavioural measures should be considered as candidates for further assessment by a sleep specialist. SN - 0305-1862 UR - https://www.unboundmedicine.com/medline/citation/16207229/Symptoms_of_inattention_and_hyperactivity_in_children_with_habitual_snoring:_evidence_from_a_community_based_study_in_Istanbul_ L2 - https://doi.org/10.1111/j.1365-2214.2005.00561.x DB - PRIME DP - Unbound Medicine ER -