Symptoms of Sleep-Disordered Breathing in 5-Year-Old Children Are Associated With Sleepiness and Problem Behaviors

Gottlieb, Daniel J.; Vezina, Richard M.; Chase, Catharine M.; Lesko, Samuel M.; Heeren, Timothy; Weese‐Mayer, Debra E.; Auerbach, Sanford; Corwin, Michael J.

doi:10.1542/peds.112.4.870

Cited by 242 publications

(179 citation statements)

References 27 publications

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“…(1) SDB has been linked to hypertension,(2) growth failure,(3) enuresis, (4,5) and impairment of cognition, attention, and executive functions. (6)(7)(8)(9)(10)(11)(12) Identification of children at high risk for SDB and its associated morbidities is particularly important given the growing body of evidence that treatment with adenotonsillectomy may improve quality of life and neurocognitive function. (5,(13)(14)(15)(16)(17) Preterm infants are especially vulnerable both to SDB and its sequelae.…”

mentioning

confidence: 99%

Prenatal and Neonatal Risk Factors for Sleep Disordered Breathing in School-Aged Children Born Preterm

Hibbs

Johnson

Rosen

et al. 2008

The Journal of Pediatrics

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Objectives-Previously published data from the Cleveland Children's Sleep and Health Study (CCSHS) demonstrated that preterm infants are especially vulnerable both to sleep disordered breathing (SDB) and its neurocognitive sequelae at age 8-11 years. In this analysis, we aimed to identify the components of the neonatal medical history associated with childhood SDB among children born prematurely.Study design-This analysis focuses on the 383 children in the population-based CCSHS cohort who were born <37 weeks gestational age and who had technically acceptable sleep studies performed at ages 8-11 years (92% of all preterm children). Logistic regression was used to evaluate the associations between candidate perinatal and neonatal risk factors and the presence of childhood SDB by sleep study.Results-Twenty-eight preterm children (7.3%) met the definition for SDB at age 8-11 years. Having a single mother and mild maternal pre-eclampsia were strongly associated with SDB in unadjusted and race-adjusted models. Unadjusted analyses also identified xanthine use and CPR and/ or intubation in the delivery room as potential risk-factors for SDB. We did not find a significant link between traditional markers of severity of neonatal illness --such as gestational age, birth weight, intraventricular hemorrhage (IVH), bronchopulmonary dysplasia (BPD), or duration of ventilation --and childhood SDB at school age.Conclusions-These results represent a first step in identifying prenatal and neonatal characteristics which place preterm infants at higher risk for childhood SDB. The strong association between mild pre-eclampsia and childhood SDB underscores the importance of research aimed at understanding in utero risk factors for neurorespiratory development. Corresponding Author: Anna Maria Hibbs, MD, MSCE, Division of Neonatology, Rainbow Babies & Children's Hospital, 11100 Euclid Avenue, Suite 3100, Cleveland, email: annamaria.hibbs@case.edu. Edited by AJ and WFB Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. (1) Furthermore, the association between sleep disordered breathing (SDB) and childhood cognitive impairment is stronger in preterm than term infants. (8) The mechanisms by which prematurity predisposes children to SDB are unknown. The association may be mediated by altered development of the lungs, airway, or nervous system. In this analysis, we aimed to identify the components of the prenatal and neonatal medical history associated with SDB occurring in children in the CCSHS studied at ages 8-11 years who had been born prematurely. NIH Public Access METHODSThe CCSHS is a po...

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mentioning

confidence: 99%

Prenatal and Neonatal Risk Factors for Sleep Disordered Breathing in School-Aged Children Born Preterm

Hibbs

Johnson

Rosen

et al. 2008

The Journal of Pediatrics

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“…Several surveys agree on a significant association between sleep-disordered breathing and behavioral disturbance in childhood [10,[36][37][38][39].…”

Section: Association Between Parasomnia and Behavioral Disordermentioning

confidence: 99%

Sleep problems, strengths and difficulties in elementary school children

Driouch¹,

Alfer²,

Fricke-Oerkermann³

et al. 2013

Health

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Aim: To assess behavioral and sleep disturbances in childhood, it is necessary to implement standardized brief questionnaires for children and their parents. Especially complaints of insomnia often are underdiagnosed in pediatric medicine. Methods: We developed a sleep questionnaire (KöSI-KJ) and used it together with German versions of the SDQ (parent and child reports) for epidemiologic studies in Cologne. The sleep questionnaire obtains 33 items for parents and 28 items for children. Ratings were dichotomized for this analysis in "sometimes/ often present" versus "not present". The German versions of SDQ contain 5 subscales each with 5 items. Data from a sample of 1490 children of fourth grade in elementary schools in Cologne (age ranged from 8 to 11 years) are shown. Results: Children indicate signs of sleep disturbances in higher frequency than their parents do. Concerning gender and ethnical group, there no significant differences can be shown. Children with signs of insomnia, dyssomnia, daytime sleepiness or restless sleep showed significantly higher scores for all relevant SDQ subscales in parental and childrens' reports. Children with signs of parasomnia showed higher scores concerning emotional problems and the SDQ total score. Children with enuresis showed higher scores for all SDQ subscales and the total score.

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“…[Patzold et al, 1998]. In a cohort of more than 3000 five-year-old children, those with sleepdisordered breathing were more likely to have daytime sleepiness and problem behaviors, including hyperactivity, inattention, and aggressiveness [Gottlieb et al, 2003]. Therefore, it is plausible that treatment of sleep disorders may impact favorably on daytime behaviors in autism and reduce stress in parents and other caregivers.…”

Section: Evaluation and Treatment Of Sleep Disorders In Autismmentioning

confidence: 99%

Sleep disorders, epilepsy, and autism

Malow

2004

Ment. Retard. Dev. Disabil. Res. Rev.

113

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The purpose of this review article is to describe the clinical data linking autism with sleep and epilepsy and to discuss the impact of treating sleep disorders in children with autism either with or without coexisting epileptic seizures. Studies are presented to support the view that sleep is abnormal in individuals with autistic spectrum disorders. Epilepsy and sleep have reciprocal relationships, with sleep facilitating seizures and seizures adversely affecting sleep architecture. The hypothesis put forth is that identifying and treating sleep disorders, which are potentially caused by or contributed to by autism, may impact favorably on seizure control and on daytime behavior. The article concludes with some practical suggestions for the evaluation and treatment of sleep disorders in this population of children with autism.

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Symptoms of Sleep-Disordered Breathing in 5-Year-Old Children Are Associated With Sleepiness and Problem Behaviors

Abstract: SDB symptoms are common in 5-year-old children and are associated with an increased risk of daytime sleepiness and with problem behaviors suggestive of attention-deficit/hyperactivity disorder.

Cited by 242 publications

References 27 publications

Prenatal and Neonatal Risk Factors for Sleep Disordered Breathing in School-Aged Children Born Preterm

Prenatal and Neonatal Risk Factors for Sleep Disordered Breathing in School-Aged Children Born Preterm

Sleep problems, strengths and difficulties in elementary school children

Sleep disorders, epilepsy, and autism

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