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Sleep-disordered breathing and behaviors of inner-city children with asthma.
Pediatrics. 2009 Jul; 124(1):218-25.Ped

Abstract

OBJECTIVE

To explore the relationship between sleep-disordered breathing (SDB) and behavioral problems among inner-city children with asthma.

METHODS

We examined data for 194 children (aged 4-10 years) who were enrolled in a school-based asthma intervention program (response rate: 72%). SDB was assessed by using the Sleep-Related Breathing Disorder Questionnaire that contains 3 subscales: snoring, sleepiness, and attention/hyperactivity. For the current study, we modified the Sleep-Related Breathing Disorder Questionnaire by removing the 6 attention/hyperactivity items. A sleep score of >0.33 was considered indicative of SDB. To assess behavior, caregivers completed the Behavior Problem Index (BPI), which includes 8 behavioral subdomains. We conducted bivariate analyses and multiple linear regression to determine the association of SDB with BPI scores.

RESULTS

The majority of children (mean age: 8.2 years) were male (56%), black (66%), and insured by Medicaid (73%). Overall, 33% of the children experienced SDB. In bivariate analyses, children with SDB had significantly higher (worse) behavior scores compared with children without SDB on total BPI (13.7 vs 8.8) and the subdomains externalizing (9.4 vs 6.3), internalizing (4.4 vs 2.5), anxious/depressed (2.4 vs 1.3), headstrong (3.2 vs 2.1), antisocial (2.3 vs 1.7), hyperactive (3.0 vs 1.8), peer conflict (0.74 vs 0.43), and immature (2.0 vs 1.5). In multiple regression models adjusting for several important covariates, SDB remained significantly associated with total BPI scores and externalizing, internalizing, anxious/depressed, headstrong, and hyperactive behaviors. Results were consistent across SDB subscales (snoring, sleepiness).

CONCLUSIONS

We found that poor sleep was independently associated with behavior problems in a large proportion of urban children with asthma. Systematic screening for SDB in this high-risk population might help to identify children who would benefit from additional intervention.

Authors+Show Affiliations

Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York 14642, USA. maria_fagnano@urmc.rochester.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19564303

Citation

Fagnano, Maria, et al. "Sleep-disordered Breathing and Behaviors of Inner-city Children With Asthma." Pediatrics, vol. 124, no. 1, 2009, pp. 218-25.
Fagnano M, van Wijngaarden E, Connolly HV, et al. Sleep-disordered breathing and behaviors of inner-city children with asthma. Pediatrics. 2009;124(1):218-25.
Fagnano, M., van Wijngaarden, E., Connolly, H. V., Carno, M. A., Forbes-Jones, E., & Halterman, J. S. (2009). Sleep-disordered breathing and behaviors of inner-city children with asthma. Pediatrics, 124(1), 218-25. https://doi.org/10.1542/peds.2008-2525
Fagnano M, et al. Sleep-disordered Breathing and Behaviors of Inner-city Children With Asthma. Pediatrics. 2009;124(1):218-25. PubMed PMID: 19564303.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sleep-disordered breathing and behaviors of inner-city children with asthma. AU - Fagnano,Maria, AU - van Wijngaarden,Edwin, AU - Connolly,Heidi V, AU - Carno,Margaret A, AU - Forbes-Jones,Emma, AU - Halterman,Jill S, PY - 2009/7/1/entrez PY - 2009/7/1/pubmed PY - 2009/9/23/medline SP - 218 EP - 25 JF - Pediatrics JO - Pediatrics VL - 124 IS - 1 N2 - OBJECTIVE: To explore the relationship between sleep-disordered breathing (SDB) and behavioral problems among inner-city children with asthma. METHODS: We examined data for 194 children (aged 4-10 years) who were enrolled in a school-based asthma intervention program (response rate: 72%). SDB was assessed by using the Sleep-Related Breathing Disorder Questionnaire that contains 3 subscales: snoring, sleepiness, and attention/hyperactivity. For the current study, we modified the Sleep-Related Breathing Disorder Questionnaire by removing the 6 attention/hyperactivity items. A sleep score of >0.33 was considered indicative of SDB. To assess behavior, caregivers completed the Behavior Problem Index (BPI), which includes 8 behavioral subdomains. We conducted bivariate analyses and multiple linear regression to determine the association of SDB with BPI scores. RESULTS: The majority of children (mean age: 8.2 years) were male (56%), black (66%), and insured by Medicaid (73%). Overall, 33% of the children experienced SDB. In bivariate analyses, children with SDB had significantly higher (worse) behavior scores compared with children without SDB on total BPI (13.7 vs 8.8) and the subdomains externalizing (9.4 vs 6.3), internalizing (4.4 vs 2.5), anxious/depressed (2.4 vs 1.3), headstrong (3.2 vs 2.1), antisocial (2.3 vs 1.7), hyperactive (3.0 vs 1.8), peer conflict (0.74 vs 0.43), and immature (2.0 vs 1.5). In multiple regression models adjusting for several important covariates, SDB remained significantly associated with total BPI scores and externalizing, internalizing, anxious/depressed, headstrong, and hyperactive behaviors. Results were consistent across SDB subscales (snoring, sleepiness). CONCLUSIONS: We found that poor sleep was independently associated with behavior problems in a large proportion of urban children with asthma. Systematic screening for SDB in this high-risk population might help to identify children who would benefit from additional intervention. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/19564303/Sleep_disordered_breathing_and_behaviors_of_inner_city_children_with_asthma_ L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=19564303 DB - PRIME DP - Unbound Medicine ER -