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Parent-Reported Symptoms of Sleep-Disordered Breathing Are Associated With Increased Behavioral Problems at 2 Years of Age: The Canadian Healthy Infant Longitudinal Development Birth Cohort Study.
Sleep. 2018 01 01; 41(1)S

Abstract

Study Objectives

To examine the association between the age of onset and duration of parent-reported symptoms of sleep-disordered breathing (SDB) and behavioral problems at age 2.

Methods

Parent-reported SDB symptoms were assessed quarterly between 3 months and 2 years among 583 Canadian Healthy Infant Longitudinal Development Edmonton-site participants. Parent-reported SDB symptoms were clustered into phenotypes using group-based trajectory analysis based on age of onset and duration of symptoms. Home-based polysomnography (PSG) was completed at 1 year. The Child Behavior Checklist preschool-version (Mean T-score 50, standard deviation 10 points) assessed total, externalizing (attention), and internalizing (anxiety, depression) behaviors at 2 years.

Results

Four phenotypes were identified: no SDB (64.7%), early-onset SDB (15.7%, peak symptoms at 9 months), late-onset (14.2%, peak symptoms at 18 months), and persistent SDB symptoms (5.3%, peak symptoms from 3 through 24 months). Persistent SDB (9.5 points, 95% CI 1.7, 17.2; p = .02) predicted the greatest magnitude of effect of total behavior problems, compared with children without SDB. Children with early-onset SDB (3.5 points, 95% CI 1.6, 5.4; p ≤ .001) and late-onset SDB (6.1 points 95% CI 4.0, 8.3; p ≤ .001) had increased total behavioral problems than children without SDB to 2 years. Additional analyses showed that the SDB phenotypes' trajectories were important for internalizing but not for externalizing behavior problems. There were no significant associations between home-PSG and parent-reported behavior problems.

Conclusions

Findings suggest that the age of onset and duration of parent-reported SDB symptoms prior to age 2 have adverse consequences for overall behavior problems.

Authors+Show Affiliations

Department of Pediatrics, University of Alberta, Edmonton, Canada.Department of Pediatrics, University of Alberta, Edmonton, Canada.Department of Pediatrics, University of Alberta, Edmonton, Canada.Educational Psychology, University of Alberta, Edmonton, Canada.Sleep Medicine, Alberta Health Services, Edmonton, Canada.Department of Pediatrics, University of Alberta, Edmonton, Canada.Division of Respirology, Department of Medicine, McMaster University, Hamilton, Canada.Department of Pediatrics, University of Toronto, Toronto, Canada. Respiratory Medicine, Hospital for Sick Children, Toronto, Canada.Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba.Department of Pediatrics, University of British Columbia, Vancouver, Canada.Division of Respirology, Department of Medicine, McMaster University, Hamilton, Canada.No affiliation info availableEducational Psychology, University of Alberta, Edmonton, Canada.Department of Pediatrics, University of Alberta, Edmonton, Canada.

Pub Type(s)

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

Language

eng

PubMed ID

29099980

Citation

Tamana, Sukhpreet K., et al. "Parent-Reported Symptoms of Sleep-Disordered Breathing Are Associated With Increased Behavioral Problems at 2 Years of Age: the Canadian Healthy Infant Longitudinal Development Birth Cohort Study." Sleep, vol. 41, no. 1, 2018.
Tamana SK, Smithson L, Lau A, et al. Parent-Reported Symptoms of Sleep-Disordered Breathing Are Associated With Increased Behavioral Problems at 2 Years of Age: The Canadian Healthy Infant Longitudinal Development Birth Cohort Study. Sleep. 2018;41(1).
Tamana, S. K., Smithson, L., Lau, A., Mariasine, J., Young, R., Chikuma, J., Lefebvre, D. L., Subbarao, P., Becker, A. B., Turvey, S. E., Sears, M. R., Pei, J., & Mandhane, P. J. (2018). Parent-Reported Symptoms of Sleep-Disordered Breathing Are Associated With Increased Behavioral Problems at 2 Years of Age: The Canadian Healthy Infant Longitudinal Development Birth Cohort Study. Sleep, 41(1). https://doi.org/10.1093/sleep/zsx177
Tamana SK, et al. Parent-Reported Symptoms of Sleep-Disordered Breathing Are Associated With Increased Behavioral Problems at 2 Years of Age: the Canadian Healthy Infant Longitudinal Development Birth Cohort Study. Sleep. 2018 01 1;41(1) PubMed PMID: 29099980.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Parent-Reported Symptoms of Sleep-Disordered Breathing Are Associated With Increased Behavioral Problems at 2 Years of Age: The Canadian Healthy Infant Longitudinal Development Birth Cohort Study. AU - Tamana,Sukhpreet K, AU - Smithson,Lisa, AU - Lau,Amanda, AU - Mariasine,Jennifer, AU - Young,Rochelle, AU - Chikuma,Joyce, AU - Lefebvre,Diana L, AU - Subbarao,Padmaja, AU - Becker,Allan B, AU - Turvey,Stuart E, AU - Sears,Malcolm R, AU - ,, AU - Pei,Jacqueline, AU - Mandhane,Piush J, PY - 2017/11/4/pubmed PY - 2019/6/14/medline PY - 2017/11/4/entrez KW - behavior KW - epidemiology KW - infants KW - population-based birth cohort KW - sleep apnea KW - sleep-disordered breathing JF - Sleep JO - Sleep VL - 41 IS - 1 N2 - Study Objectives: To examine the association between the age of onset and duration of parent-reported symptoms of sleep-disordered breathing (SDB) and behavioral problems at age 2. Methods: Parent-reported SDB symptoms were assessed quarterly between 3 months and 2 years among 583 Canadian Healthy Infant Longitudinal Development Edmonton-site participants. Parent-reported SDB symptoms were clustered into phenotypes using group-based trajectory analysis based on age of onset and duration of symptoms. Home-based polysomnography (PSG) was completed at 1 year. The Child Behavior Checklist preschool-version (Mean T-score 50, standard deviation 10 points) assessed total, externalizing (attention), and internalizing (anxiety, depression) behaviors at 2 years. Results: Four phenotypes were identified: no SDB (64.7%), early-onset SDB (15.7%, peak symptoms at 9 months), late-onset (14.2%, peak symptoms at 18 months), and persistent SDB symptoms (5.3%, peak symptoms from 3 through 24 months). Persistent SDB (9.5 points, 95% CI 1.7, 17.2; p = .02) predicted the greatest magnitude of effect of total behavior problems, compared with children without SDB. Children with early-onset SDB (3.5 points, 95% CI 1.6, 5.4; p ≤ .001) and late-onset SDB (6.1 points 95% CI 4.0, 8.3; p ≤ .001) had increased total behavioral problems than children without SDB to 2 years. Additional analyses showed that the SDB phenotypes' trajectories were important for internalizing but not for externalizing behavior problems. There were no significant associations between home-PSG and parent-reported behavior problems. Conclusions: Findings suggest that the age of onset and duration of parent-reported SDB symptoms prior to age 2 have adverse consequences for overall behavior problems. SN - 1550-9109 UR - https://www.unboundmedicine.com/medline/citation/29099980/Parent_Reported_Symptoms_of_Sleep_Disordered_Breathing_Are_Associated_With_Increased_Behavioral_Problems_at_2_Years_of_Age:_The_Canadian_Healthy_Infant_Longitudinal_Development_Birth_Cohort_Study_ L2 - https://academic.oup.com/sleep/article-lookup/doi/10.1093/sleep/zsx177 DB - PRIME DP - Unbound Medicine ER -