Sleepiness in children linked to obesity, asthma

Obese, asthmatic, anxious or depressed children are more likely to experience excessive daytime sleepiness, or EDS, according to Penn State College of Medicine sleep researchers.

"Although EDS in children is commonly assumed by physicians and the public to be the result of sleep-disordered breathing or inadequate sleep, our data suggest that EDS in young children is more strongly associated with obesity and mood issues as it is in adults," said Edward Bixler, Ph.D., professor of psychiatry and vice chair of research, Sleep Research and Treatment Center.

EDS is the inability to stay awake during the day, while sleep-disordered breathing is a group of disorders that includes sleep apnea, characterized by pauses in breathing.

"EDS may interfere with daytime functioning in children, including academic performance," said Bixler. "Although excessive daytime sleepiness in adults has been the focus of extensive research, studies on the risk factors associated with EDS in children have been limited."

The researchers studied 508 children and found EDS in 15 percent of them.

"Our study indicates that EDS is highly prevalent in children, a symptom that may adversely affect daytime functioning," said Bixler.

This study suggests an association between childhood EDS and medical factors, medication for asthma, waist circumference, and parent-reported anxiety/depression and parent-reported sleep difficulties – trouble falling asleep, restless sleep and waking often during the night.

Researchers conducted a two-phase study to look at the issue. In phase I, a screening questionnaire to identify children at high risk for sleep-disordered breathing was sent to parents of every student in kindergarten through fifth grade in four school districts. The questionnaire asked for general information from parents about their child's sleep and behavioral patterns.

In phase II, the researchers randomly selected 200 children each year for five years based on grade, gender and risk for sleep-disordered breathing. In all, they chose 508 children for the study, including those with medical problems and mental health disorders, to represent the general population.

The researchers recorded height, weight, body mass index, and waist circumference - a marker of central obesity and metabolic abnormalities - for each child. All children spent one night in a sleep laboratory and were screened for sleep apnea - defined as at least five seconds of breathing stoppage while sleeping.

Parents completed a sleep questionnaire to assess EDS. If the parent reported yes for one or both of the questions, "Does your child have a problem with sleepiness during the day?" and "Has a teacher or other supervisor commented that your child appears sleepy during the day?" the researchers classified the children as having EDS.