• Judith A Owens, Robyn Mehlenbeck, Juhee Lee, and Melissa M King.
• Rhode Island Hospital, 593 Eddy St, Potter Bldg, Ste 200, Providence, RI 02903, USA. owensleep@gmail.com
• Arch Pediatr Adolesc Med. 2008 Apr 1; 162 (4): 313-21.

ObjectiveTo assess the relative contribution of potential risk factors for adverse neurobehavioral outcomes in children referred for evaluation of sleep-disordered breathing (SDB), including weight, mean sleep duration, and comorbid sleep disorders.DesignMedical record review.SettingAcademic pediatric medical center.ParticipantsClinical sample of 235 children aged 3 to 18 years undergoing overnight polysomnography for symptoms of SDB.Outcome MeasuresHistory of behavioral, emotional, and academic problems and Child Behavior Checklist (CBCL) scores.ResultsMore than half (56%) of the sample was overweight or at risk for overweight, more than one-third (36%) was classified as being short sleepers, and almost half (49%) had at least 1 additional sleep diagnosis. Forty-seven percent had a history of behavioral problems and 23% had a reported diagnosis of attention-deficit/hyperactivity disorder. There were no significant differences in CBCL scores based on any measure of SDB disease severity. Increased weight was associated with increased internalizing CBCL scores in a dose-dependent fashion (P = .003), while short sleepers were more likely to have elevated externalizing scores (P < .001). Overall, the strongest predictor of adverse behavioral outcomes was the presence of at least 1 additional sleep diagnosis (P < .001).ConclusionsThe relationship between SDB and parent-reported behavioral outcomes in children is complex. In addition to SDB-related impairments, clinicians should consider the relative contributions of being overweight, insufficient sleep, and comorbid sleep disorders when assessing behavior in these children.

26 keywords...

hide…