Snoring, mouth-breathing, and apnea trajectories in a population-based cohort followed from infancy to 81 months: A cluster analysis

Freeman, Katherine; Bonuck, Karen

doi:10.1016/j.ijporl.2011.10.019

Cited by 23 publications

(20 citation statements)

References 56 publications

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“…Definitions of SDB vary, thus hampering accurate prevalence data, but a recent review of the epidemiology of pediatric SDB reported that "always snoring" occurs in 1.5% to 6.0% of children, with various constellations of SDB symptoms reported by questionnaire to occur in 4% to 20% of children. 1,2 Objective evidence of SDB from polysomnography, using various criteria, occurs in approximately 1% to 4% of children. 2 The major risk factors for pediatric SDB are adenotonsillar hypertrophy and obesity.…”

Section: Prevalence and Risk Factorsmentioning

confidence: 99%

Sleep-Related Breathing Disorder, Cognitive Functioning, and Behavioral-Psychiatric Syndromes in Children

O’Brien

2015

Sleep Medicine Clinics

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Section: Prevalence and Risk Factorsmentioning

confidence: 99%

Sleep-Related Breathing Disorder, Cognitive Functioning, and Behavioral-Psychiatric Syndromes in Children

O’Brien

2015

Sleep Medicine Clinics

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“…Through a process described in detail elsewhere, 37 we produced 5 conceptually and statistically distinct Early clusters (6-42 months), and 5 comparable Later clusters (6-69 months) that were extensions of Early clusters.…”

Section: Behavior Assessmentmentioning

confidence: 99%

Sleep-Disordered Breathing in a Population-Based Cohort: Behavioral Outcomes at 4 and 7 Years

et al. 2012

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WHAT'S KNOWN ON THIS SUBJECT: Sleep-disordered breathing is associated with neurobehavioral morbidity in children. Prior related research has generally been cross-sectional or short (ie, 1-2 years) follow-up studies of a single symptom (ie, snoring, obstructive sleep apnea, mouth breathing), with limited control for confounders.WHAT THIS STUDY ADDS: Sleep-disordered breathing was assessed as a trajectory of combined symptoms from 6 months to 69 months, in more than 11 000 children. Sleep-disordered breathing was associated with 40% and 60% more behavioral difficulties at 4 and 7 years, respectively. abstract OBJECTIVES: Examine statistical effects of sleep-disordered breathing (SDB) symptom trajectories from 6 months to 7 years on subsequent behavior. METHODS:Parents in the Avon Longitudinal Study of Parents and Children reported on children' s snoring, mouth breathing, and witnessed apnea at $2 surveys at 6, 18, 30, 42, 57, and 69 months, and completed the Strengths and Difficulties Questionnaire at 4 (n = 9140) and 7 (n = 8098) years. Cluster analysis produced 5 "Early" (6-42 months) and "Later" (6-69 months) symptom trajectories ("clusters"). Adverse behavioral outcomes were defined by top 10th percentiles on Strengths and Difficulties Questionnaire total and subscales, at 4 and 7 years, in multivariable logistic regression models. RESULTS:The SDB clusters predicted 20% to 100% increased odds of problematic behavior, controlling for 15 potential confounders. Early trajectories predicted problematic behavior at 7 years equally well as at 4 years. In Later trajectories, the "Worst Case" cluster, with peak symptoms at 30 months that abated thereafter, nonetheless at 7 years predicted hyperactivity (1.85 [1.30-2.63]), and conduct (1.60 [1.18-2.16]) and peer difficulties (1.37 [1.04-1.80]), whereas a "Later Symptom" cluster predicted emotional difficulties (1.65 [1.21-2.07]) and hyperactivity (1.88 [1.42-2.49]) . The 2 clusters with peak symptoms before 18 months that resolve thereafter still predicted 40% to 50% increased odds of behavior problems at 7 years. CONCLUSIONS:In this large, population-based, longitudinal study, early-life SDB symptoms had strong, persistent statistical effects on subsequent behavior in childhood. Findings suggest that SDB symptoms may require attention as early as the first year of life. Pediatrics 2012;129:e857-e865

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“…59 Still, the SDB items are similar to those validated against objective measures, 60-64 while the clusters themselves may better capture the dynamic, multisymptom expression of SDB. 24 Our BSP measure corresponds to one used in earlier ALSPAC analyses. 25,26 Second, ALSPAC data did not specify the disabilities that qualified a child for SENs.…”

Section: Discussionmentioning

confidence: 99%

“…24 Clusters were derived for children with SDB measures at $2 of these 5 time points. Briefly, this process yielded 5 unique symptom patterns, or clusters (see Fig 1 A-E), depicting the prevalence of snoring, mouth-breathing, and apnea in SD or z scores, at 6, 18, 30, 42, and 57 months of age.…”

Section: Assessment Of Senmentioning

confidence: 99%

Pediatric Sleep Disorders and Special Educational Need at 8 Years: A Population-Based Cohort Study

Bonuck

Rao

2012

Pediatrics

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Snoring, mouth-breathing, and apnea trajectories in a population-based cohort followed from infancy to 81 months: A cluster analysis

Cited by 23 publications

References 56 publications

Sleep-Related Breathing Disorder, Cognitive Functioning, and Behavioral-Psychiatric Syndromes in Children

Sleep-Related Breathing Disorder, Cognitive Functioning, and Behavioral-Psychiatric Syndromes in Children

Sleep-Disordered Breathing in a Population-Based Cohort: Behavioral Outcomes at 4 and 7 Years

Pediatric Sleep Disorders and Special Educational Need at 8 Years: A Population-Based Cohort Study

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