STUDY OBJECTIVES: This study analyzed the association between the Respiratory Disturbance Index (RDI) and two behavior measures, the Conners' Parent Rating Scale (CPRS-R) and the Child Behavior Checklist (CBCL) in school-aged children to determine whether there is an optimal threshold of Sleep-disordered Breathing (SDB) associated with increased risk of behavior problems. METHODS: The Tucson Children's Assessment of Sleep Apnea Study (TuCASA) is an observational cohort study of 6-11 year old Caucasian and Hispanic children designed to assess the anatomic, physiologic and neurocognitive correlates of SDB. 403 children with both polysomnography (PSG) and behavioral data were included in this analysis. Three definitions of SDB were used: RDI independent of oxygen desaturation (RDI0), RDI with 2% oxygen desaturation (RDI2) and RDI with 3% oxygen desaturation (RDI3). T-scored behavioral data were dichotomized at a cutoff point of 65, a score indicative of moderate to severe clinical impairment. Logistic regression was used to access the risk associated with SDB. RESULTS: The analyses conducted using three different definitions of RDI suggest that the likelihood of having a clinically significant CPRS-R or CBCL subscale score was not necessarily progressive or linear across RDI categories. Cutoff points and prevalences for each definition of RDI proposed to be indicators of clinically significant SDB were RDI0 ≥ 7 (19.38%), RDI2 ≥ 2 (29.38%) and RDI3 ≥ 0.5 (23.96%) events per hour of sleep. Behaviors such as CPRS oppositional, social problems, psychosomatic and CBCL somatic complaints, social problems and aggressive behaviors were found to be significantly associated with SDB. CONCLUSIONS: This analysis found an increased risk of behavior problems such as somatic complaints, oppositional or aggressive behaviors and social problems associated with sleep-disordered breathing in school-aged children. RDI cut points for three definitions of SDB are proposed: 7 for RDI0, 2 for RDI2, and 0.5 for RDI3 respectively.
STUDY OBJECTIVES: This study analyzed the association between the Respiratory Disturbance Index (RDI) and two behavior measures, the Conners' Parent Rating Scale (CPRS-R) and the Child Behavior Checklist (CBCL) in school-aged children to determine whether there is an optimal threshold of Sleep-disordered Breathing (SDB) associated with increased risk of behavior problems. METHODS: The Tucson Children's Assessment of Sleep Apnea Study (TuCASA) is an observational cohort study of 6-11 year old Caucasian and Hispanic children designed to assess the anatomic, physiologic and neurocognitive correlates of SDB. 403 children with both polysomnography (PSG) and behavioral data were included in this analysis. Three definitions of SDB were used: RDI independent of oxygen desaturation (RDI0), RDI with 2% oxygen desaturation (RDI2) and RDI with 3% oxygen desaturation (RDI3). T-scored behavioral data were dichotomized at a cutoff point of 65, a score indicative of moderate to severe clinical impairment. Logistic regression was used to access the risk associated with SDB. RESULTS: The analyses conducted using three different definitions of RDI suggest that the likelihood of having a clinically significant CPRS-R or CBCL subscale score was not necessarily progressive or linear across RDI categories. Cutoff points and prevalences for each definition of RDI proposed to be indicators of clinically significant SDB were RDI0 ≥ 7 (19.38%), RDI2 ≥ 2 (29.38%) and RDI3 ≥ 0.5 (23.96%) events per hour of sleep. Behaviors such as CPRS oppositional, social problems, psychosomatic and CBCL somatic complaints, social problems and aggressive behaviors were found to be significantly associated with SDB. CONCLUSIONS: This analysis found an increased risk of behavior problems such as somatic complaints, oppositional or aggressive behaviors and social problems associated with sleep-disordered breathing in school-aged children. RDI cut points for three definitions of SDB are proposed: 7 for RDI0, 2 for RDI2, and 0.5 for RDI3 respectively.
Authors: Ronald D Chervin; James E Dillon; Kristen Hedger Archbold; Deborah L Ruzicka Journal: J Am Acad Child Adolesc Psychiatry Date: 2003-02 Impact factor: 8.829
Authors: Louise M O'Brien; Cheryl R Holbrook; Carolyn B Mervis; Carrie J Klaus; Jennifer L Bruner; Troy J Raffield; Jennifer Rutherford; Rochelle C Mehl; Mei Wang; Andrew Tuell; Brittany C Hume; David Gozal Journal: Pediatrics Date: 2003-03 Impact factor: 7.124
Authors: Carol L Rosen; Amy Storfer-Isser; H Gerry Taylor; H Lester Kirchner; Judith L Emancipator; Susan Redline Journal: Pediatrics Date: 2004-12 Impact factor: 7.124
Authors: Louise M O'Brien; Carolyn B Mervis; Cheryl R Holbrook; Jennifer L Bruner; Nigel H Smith; Nechia McNally; M Catherine McClimment; David Gozal Journal: J Sleep Res Date: 2004-06 Impact factor: 3.981
Authors: Susan L Calhoun; Julio Fernandez-Mendoza; Alexandros N Vgontzas; Susan D Mayes; Duanping Liao; Edward O Bixler Journal: J Abnorm Child Psychol Date: 2017-02
Authors: Michelle M Perfect; Priti G Patel; Roxanne E Scott; Mark D Wheeler; Chetanbabu Patel; Kurt Griffin; Seth T Sorensen; James L Goodwin; Stuart F Quan Journal: Sleep Date: 2012-01-01 Impact factor: 5.849
Authors: Michelle M Perfect; Kristen Archbold; James L Goodwin; Deborah Levine-Donnerstein; Stuart F Quan Journal: Sleep Date: 2013-04-01 Impact factor: 5.849
Authors: Sukhpreet K Tamana; Lisa Smithson; Amanda Lau; Jennifer Mariasine; Rochelle Young; Joyce Chikuma; Diana L Lefebvre; Padmaja Subbarao; Allan B Becker; Stuart E Turvey; Malcolm R Sears; Jacqueline Pei; Piush J Mandhane Journal: Sleep Date: 2018-01-01 Impact factor: 5.849
Authors: Gloria Reeves; Carol Blaisdell; Manana Lapidus; Patricia Langenberg; Maya Ramagopal; Johanna Cabassa; Mary Beth Bollinger; Gagan Virk Nijjar; Bruno Anthony; Thomas Achenbach; Teodor T Postolache Journal: Int J Adolesc Med Health Date: 2010 Oct-Dec
Authors: Sarah N Biggs; Anna Vlahandonis; Vicki Anderson; Robert Bourke; Gillian M Nixon; Margot J Davey; Rosemary S C Horne Journal: Sleep Date: 2014-01-01 Impact factor: 5.849