In response to mailed questionnaires, parents reported their child's snoring and apnea at 18, 30, 42, and 57 months of age. For the same time intervals, parents were also asked whether their child refused to go to bed, and whether they regularly woke early, had difficulty sleeping, had nightmares, got up after being put to bed, woke in the night, or awakened after a few hours. Children with five or more of these behaviors simultaneously were considered to have a clinically significant behavioral sleep problem.
The prevalence of behavioral sleep problems over the 18to 57-month age reporting period ranged from 15 to 27 percent with a peak at 30 months of age. Among children with behavioral sleep problems, 26 to 40 percent had habitual SDB, again peaking at 30 months. Among children who had habitual SDB, 25 to 37 percent also had a behavioral sleep problem, peaking at 30 months.
While it is unlikely that behavioral sleep problems cause SDB, the converse may be true, noted Dr. Bonuck. Frequent night wakings initially related to SDB may be reinforced by the parents' anxious responses. These behaviors may, in turn, develop into a persistent behavioral sleep problem, despite adequate treatment for SDB.
"It's important that we pay attention to how our children are sleeping," said Dr. Bonuck. "There's ample evidence that anything that interrupts sleep can negatively affect a child's emotional, cognitive, behavioral and academic development. Fortunately, snoring and apnea are highly treatable, and there are many effective interventions for behavioral sleep problems."
|Contact: Kim Newman|
Albert Einstein College of Medicine