Last Updated: 2009-07-10 16:05:34 -0400 (Reuters Health)

Sleep-disordered breathing (SDB) is associated with behavior problems in children with asthma, according to a paper in the July issue of Pediatrics.

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’ study involved 194 inner-city children with asthma who were between the ages of 4 and 10 years (mean age, 8.2). On the basis of scores on the Sleep-Related Breathing Disorder scale, 33% of the children had SDB, the investigators report. Also, they found, on the basis of caregiver responses on the Behavioral Problem Index (BPI), 32% of children had significant behavioral issues.

Children with SDB had significantly worse behavior scores overall 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 associated with total BPI scores and eternalizing, internalizing, anxious/depressed, headstrong, and hyperactive behaviors. Similar significant associations were observed 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."

Pediatrics 2009;124:218-225.

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