Dr. Maria Fagnano and colleagues from the University of Rochester School of Medicine, New York, write, Studies have linked asthma symptoms with both childhood behavior problems and troubled sleep. There is growing, but limited, evidence that children with SDB may have worse behavior.
The investigators studied 194 inner-city children with asthma aging between 4 and 10 years (mean age, 8.2). Sleep-Related Breathing Disorder scale showed that 33% of the children had SDB. On the basis of caregiver responses on the Behavioral Problem Index (BPI), the investigators also found that 32% of children had significant behavioral issues.
Children with SDB significantly had overall worse behavior scores compared to those with no sleep difficulties (p<0.001), as well as worse scores on subdomains for externalizing (p<0.001), internalizing (p<0.001), anxious/depressed (p<0.001), headstrong (p<0.001), antisocial (p=0.013), hyperactive (p<0.001), peer conflict (p=0.011), and immature (p=0.014).
On multiple regression analyses, SBD remained significantly linked to total BPI scores and eternalizing, internalizing, anxious/depressed, headstrong, and hyperactive behaviors. There were similar significant associations between higher sleep scores and worse behaviors across sleep subscales (snoring and sleepiness).
Additional investigation is needed to determine if treatment of sleep disorders would help to decrease behavior problems in this population, the authors said.
In the meantime, the researchers conclude, Clinicians should be particularly diligent about screening all children with asthma for SDB, and consider sleep disorders as a possible risk factor for behavior problems.
