@article{ref1,
title="Sleep-Disordered Breathing in a Population-Based Cohort: Behavioral Outcomes at 4 and 7 Years",
journal="Pediatrics",
year="2012",
author="Bonuck, Karen and Freeman, Katherine and Chervin, Ronald D. and Xu, Linzhi",
volume="129",
number="4",
pages="e857-65",
abstract="OBJECTIVES:Examine statistical effects of sleep-disordered breathing (SDB) symptom trajectories from 6 months to 7 years on subsequent behavior.METHODS:Parents in the Avon Longitudinal Study of Parents and Children reported on children's snoring, mouth breathing, and witnessed apnea at ≥2 surveys at 6, 18, 30, 42, 57, and 69 months, and completed the Strengths and Difficulties Questionnaire at 4 (n = 9140) and 7 (n = 8098) years. Cluster analysis produced 5 &quot;Early&quot; (6-42 months) and &quot;Later&quot; (6-69 months) symptom trajectories (&quot;clusters&quot;). Adverse behavioral outcomes were defined by top 10th percentiles on Strengths and Difficulties Questionnaire total and subscales, at 4 and 7 years, in multivariable logistic regression models.RESULTS:The SDB clusters predicted ≈20% to 100% increased odds of problematic behavior, controlling for 15 potential confounders. Early trajectories predicted problematic behavior at 7 years equally well as at 4 years. In Later trajectories, the &quot;Worst Case&quot; cluster, with peak symptoms at 30 months that abated thereafter, nonetheless at 7 years predicted hyperactivity (1.85 [1.30-2.63]), and conduct (1.60 [1.18-2.16]) and peer difficulties (1.37 [1.04-1.80]), whereas a &quot;Later Symptom&quot; cluster predicted emotional difficulties (1.65 [1.21-2.07]) and hyperactivity (1.88 [1.42-2.49]) . The 2 clusters with peak symptoms before 18 months that resolve thereafter still predicted 40% to 50% increased odds of behavior problems at 7 years.CONCLUSIONS:In this large, population-based, longitudinal study, early-life SDB symptoms had strong, persistent statistical effects on subsequent behavior in childhood. Findings suggest that SDB symptoms may require attention as early as the first year of life.<p /> <p>Language: en</p>",
language="en",
issn="0031-4005",
doi="10.1542/peds.2011-1402",
url="http://dx.doi.org/10.1542/peds.2011-1402"
}