Increased behavioral problems in children with sleep-disordered breathing

• Published in: Italian journal of pediatrics Vol. 48; no. 1; pp. 1 - 7
• Main Authors: Csábi, Eszter, Gaál, Veronika, Hallgató, Emese, Schulcz, Rebeka Anna, Katona, Gábor, Benedek, Pálma
• Format: Journal Article
• Language: English
• Published: London BioMed Central 15.09.2022; BMC
• Subjects: Aggressive behavior; Airway management; Apnea; Attention deficit hyperactivity disorder; Behavior; Behavior dysregulation; Children; Cognitive ability; Emotional behavior; Executive function; Hyperactivity; Impulsivity; Inattentiveness children; Laboratories; Maternal and Child Health; Medicine; Medicine & Public Health; Neurological disorders; Oxygen saturation; Pediatric Neurology; Pediatrics; Quality of life; Questionnaires; Sleep apnea; Sleep disorders; Sleep-disordered breathing; Snoring; Statistical analysis; Hungary; Behavior dysregulation; Inattentiveness children; Sleep apnea; Hyperactivity; Sleep-disordered breathing; Snoring
• ISSN: 1824-7288; 1720-8424; 1824-7288
• DOI: 10.1186/s13052-022-01364-w

Background Healthy sleep is essential for the cognitive, behavioral and emotional development of children. Therefore, this study aimed to assess the behavioral consequences of sleep disturbances by examining children with sleep-disordered breathing compared with control participants. Methods Seventy-eight children with SDB (average age: 6.7 years (SD = 1.83); 61 had OSA and 17 had primary snoring) and 156 control subjects (average age: 6.57 years (SD = 1.46) participated in the study. We matched the groups in age ( t (232) = 0.578, p  = 0.564) and gender ( χ 2 (1) = 2.192, p  = 0.139). In the SDB group, the average Apnea–Hypopnea Index was 3.44 event/h (SD = 4.00), the average desaturation level was 87.37% (SD = 6.91). Parent-report rating scales were used to measure the children’s daytime behavior including Attention Deficit Hyperactivity Disorder Rating Scale, Strengths and Difficulties Questionnaire, and Child Behavior Checklist. Results Our results showed that children with SDB exhibited a higher level of inattentiveness and hyperactive behavior. Furthermore, the SDB group demonstrated more internalizing (anxiety, depression, somatic complaints, social problems) ( p  < 0.001) and externalizing (aggressive and rule-breaking behavior) problems compared with children without SDB, irrespective of severity. Conclusions Based on our findings we supposed that snoring and mild OSA had a risk for developing behavioral and emotional dysfunctions as much as moderate-severe OSA. Therefore, clinical research and practice need to focus more on the accurate assessment and treatment of sleep disturbances in childhood, particularly primary snoring, and mild obstructive sleep apnea.