STUDY OBJECTIVES: Cross-sectional studies implicate snoring and sleep-disordered breathing as potential contributors to hyperactive behavior in some children. However, no prospective cohort study has demonstrated that symptoms of sleep-disordered breathing precede development of hyperactivity. PARTICIPANTS: Parents of 229 children aged 2 to 13 years, recruited at 2 general pediatrics clinics, completed initial and 4-year follow-up surveys. MEASUREMENTS: Surveys included a validated Pediatric Sleep Questionnaire about snoring, sleepiness, and overall risk of sleep-disordered breathing, and the hyperactivity index (expressed as a T-score) within the Conners' Parent Rating Scale. RESULTS: Thirty children (13%) were rated as hyperactive (hyperactivity index > 60) at follow-up. After adjustment for hyperactivity at baseline and stimulant use at follow-up, hyperactivity at follow-up was predicted by baseline habitual snoring (odds ratio = 4.4, 95% confidence interval [1.3, 14.7]) or loud snoring (4.5, [1.2, 17.5]) and by top-quartile composite scores for snoring (5.3, [1.7, 16.8]), sleepiness (3.0, [1.0, 9.4]), or sleep-disordered breathing (4.0, [1.4, 11.6]). CONCLUSIONS: This 4-year prospective cohort study shows that snoring and other symptoms of sleep-disordered breathing are strong risk factors for future emergence or exacerbation of hyperactive behavior. These findings support the hypothesis that untreated childhood sleep-disordered breathing contributes to development of hyperactivity.
STUDY OBJECTIVES: Cross-sectional studies implicate snoring and sleep-disordered breathing as potential contributors to hyperactive behavior in some children. However, no prospective cohort study has demonstrated that symptoms of sleep-disordered breathing precede development of hyperactivity. PARTICIPANTS: Parents of 229 children aged 2 to 13 years, recruited at 2 general pediatrics clinics, completed initial and 4-year follow-up surveys. MEASUREMENTS: Surveys included a validated Pediatric Sleep Questionnaire about snoring, sleepiness, and overall risk of sleep-disordered breathing, and the hyperactivity index (expressed as a T-score) within the Conners' Parent Rating Scale. RESULTS: Thirty children (13%) were rated as hyperactive (hyperactivity index > 60) at follow-up. After adjustment for hyperactivity at baseline and stimulant use at follow-up, hyperactivity at follow-up was predicted by baseline habitual snoring (odds ratio = 4.4, 95% confidence interval [1.3, 14.7]) or loud snoring (4.5, [1.2, 17.5]) and by top-quartile composite scores for snoring (5.3, [1.7, 16.8]), sleepiness (3.0, [1.0, 9.4]), or sleep-disordered breathing (4.0, [1.4, 11.6]). CONCLUSIONS: This 4-year prospective cohort study shows that snoring and other symptoms of sleep-disordered breathing are strong risk factors for future emergence or exacerbation of hyperactive behavior. These findings support the hypothesis that untreated childhood sleep-disordered breathing contributes to development of hyperactivity.
Authors: Maria Fagnano; Edwin van Wijngaarden; Heidi V Connolly; Margaret A Carno; Emma Forbes-Jones; Jill S Halterman Journal: Pediatrics Date: 2009-07 Impact factor: 7.124
Authors: Louise M O'Brien; Neali H Lucas; Barbara T Felt; Timothy F Hoban; Deborah L Ruzicka; Ruth Jordan; Kenneth Guire; Ronald D Chervin Journal: Sleep Med Date: 2011-05-26 Impact factor: 3.492
Authors: Thornton B A Mason; Raanan Arens; Jaclyn Sharman; Brooke Bintliff-Janisak; Brian Schultz; Arthur S Walters; Jacqueline R Cater; Paige Kaplan; Allan I Pack Journal: Sleep Med Date: 2011-09-21 Impact factor: 3.492
Authors: Ronald D Chervin; Susan L Garetz; Deborah L Ruzicka; Elise K Hodges; Bruno J Giordani; James E Dillon; Barbara T Felt; Timothy F Hoban; Kenneth E Guire; Louise M O'Brien; Joseph W Burns Journal: J Clin Sleep Med Date: 2014-08-15 Impact factor: 4.062