Kids' sleep disorders linked with problem behavior

Sleep-disordered breathing is associated with higher rates of behavioral problems in children, researchers report.

Sleep-disordered breathing covers a range of conditions, from snoring to obstructive sleep apnea in which breathing is blocked for short but frequent periods during sleep.

While many studies have reported more behavioral problems in children with suspected sleep-disordered breathing, "those studies could be biased by an over-referral of children with behavioral problems," lead investigator Dr. Carol L. Rosen told AMN Health.

To avoid this possibility, Rosen and her colleagues at the Case Western Reserve University School of Medicine in Cleveland, Ohio, conducted a community-based survey involving 829 children ages 8 to 11 years old.

Sleep-disordered breathing was defined either by parents' reports that their child habitual snored or by measures of sleep apnea obtained by overnight monitoring. Two well-validated scales were used to obtain parental ratings of kids' behavior.

Overall, 5 percent of the children were classified as having sleep apnea, 15 percent had snoring without sleep apnea, and the remaining 80 percent had neither condition, according the researchers' article in the medical journal Pediatrics.

Children with sleep-disordered breathing were significantly more likely to have problems such as emotional instability, hyperactivity, aggressive behavior and socializing difficulties.

"Finding this relationship in a non-clinical, non-referred community-based sample of children strengthens the relationship between sleep-disordered breathing and behavioral problems," Rosen noted.

However, the findings don't prove that sleep problems cause behavior problems. "Well-controlled studies looking at the reversibility of behavioral problems with treatment of sleep-disorder breathing are needed to answer the question of causality," Rosen concluded.

SOURCE: Pediatrics, December 2004.