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Discover Pediatric Collections on COVID-19 and Racism and Its Effects on Pediatric Health

American Academy of Pediatrics
Article

Pediatric Sleep Disorders and Special Educational Need at 8 Years: A Population-Based Cohort Study

Karen Bonuck, Trupti Rao and Linzhi Xu
Pediatrics October 2012, 130 (4) 634-642; DOI: https://doi.org/10.1542/peds.2012-0392
Karen Bonuck
aDepartment of Family Medicine, Albert Einstein College of Medicine, Bronx, New York;
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Trupti Rao
bWestchester Institute for Human Development, New York Medical College, Center on Disability and Health, Valhalla, New York; and
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Linzhi Xu
cDepartment of Pediatrics, Baylor College of Medicine, Houston, Texas
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Abstract

OBJECTIVES: To examine associations between sleep-disordered breathing (SDB) and behavioral sleep problems (BSPs) through 5 years of age and special educational need (SEN) at 8 years.

METHODS: Parents in the Avon Longitudinal Study of Parents and Children reported on children’s snoring, witnessed apnea, and mouth-breathing at 6, 18, 30, 42, and 57 months, from which SDB symptom trajectories, or clusters, were derived. BSPs were based on report of ≥5 of 7 sleep behaviors at each of the 18-, 30-, 42-, and 57-month questionnaires. Parent report of SEN (yes/no) at 8 years was available for 11 049 children with SDB data and 11 467 children with BSP data. Multivariable logistic regression models were used to predict SEN outcome by SDB cluster and by cumulative report of SEN.

RESULTS: Controlling for 16 putative confounders, previous history of SDB and BSPs was significantly associated with an SEN. BSPs were associated with a 7% increased odds of SEN (95% confidence interval [CI] 1.01–1.15), for each ∼1-year interval at which a BSP was reported. SDB, overall, was associated with a near 40% increased odds of SEN (95% CI 1.18–1.62). Children in the worst symptom cluster were 60% more likely to have an SEN (95% CI 1.23–2.08).

CONCLUSIONS: In this population-based longitudinal study, history of either SDB or BSPs in the first 5 years of life was associated with increased likelihood of SEN at 8 years of age. Findings highlight the need for pediatric sleep disorder screening by early interventionists, early childhood educators, and health professionals.

KEY WORDS
  • sleep-disordered breathing
  • behavior sleep problem
  • longitudinal
  • special education
  • Abbreviations:
    ALSPAC —
    Avon Longitudinal Study of Parents and Children
    BSP —
    behavioral sleep problem
    CI —
    confidence interval
    OR —
    odds ratio
    SDB —
    sleep disordered breathing
    SEN —
    special educational need
    SES —
    socioeconomic status
    • Accepted May 16, 2012.
    • Copyright © 2012 by the American Academy of Pediatrics

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    Pediatrics
    Vol. 130, Issue 4
    1 Oct 2012
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    Pediatric Sleep Disorders and Special Educational Need at 8 Years: A Population-Based Cohort Study
    Karen Bonuck, Trupti Rao, Linzhi Xu
    Pediatrics Oct 2012, 130 (4) 634-642; DOI: 10.1542/peds.2012-0392

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    Pediatric Sleep Disorders and Special Educational Need at 8 Years: A Population-Based Cohort Study
    Karen Bonuck, Trupti Rao, Linzhi Xu
    Pediatrics Oct 2012, 130 (4) 634-642; DOI: 10.1542/peds.2012-0392
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    • behavior sleep problem
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