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Cited by 538Obstructive Sleep Apnea ResearchSleep and related disordersAttention Deficit Hyperactivity Disorder

Inattention, Hyperactivity, and Symptoms of Sleep-Disordered Breathing

Chervin, R. D., Archbold, K. H., Dillon, J. E., Panahi, P., Pituch, K. J., Dahl, R. E., Guilleminault, C.·2002·PEDIATRICS
DOI 10.1542/peds.109.3.449
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Abstract

OBJECTIVE: Inattention and hyperactivity are frequent among children with sleep-disordered breathing (SDB) and often improve when SDB is treated. However, the frequency of SDB symptoms among inattentive and hyperactive children has received little study. DESIGN: Cross-sectional survey. SETTING: Two university-affiliated but community-based general pediatrics clinics. PATIENTS: Patients consisted of N = 866 children (469 boys), aged 2.0 to 13.9 years (mean: 6.8 plus minus 3.2 years), with clinic appointments. MEASURES: A validated Pediatric Sleep Questionnaire assessed for habitual snoring (1 item), snoring severity (a 4-item subscale), sleepiness (4 items), and overall risk of SDB (16 items). Parents also completed 2 common behavioral measures, an inattention/hyperactivity scale (IHS) derived from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and the hyperactivity index (HI, expressed as a t score) of the Conners' Parent Rating Scale. RESULTS: Habitual snoring was reported in 16% (95% confidence interval [CI]: 13, 19) of the participants. High HI scores (>60) were found in 13% (95% CI: 11, 16) of all participants, 22% (95% CI: 15, 29) of habitual snorers, and 12% (95% CI: 9, 14) of nonsnorers. Odds ratios between HI >60 and each of the following were: habitual snoring, 2.2 (95% CI: 1.4, 3.6); 1 additional positive symptom-item on the snoring scale, 1.3 (95% CI: 1.1, 1.5); 1 additional positive item on the sleepiness scale, 1.6 (95% CI: 1.4, 2.0); and a 1-standard deviation increase in the overall SDB score, 1.7 (95% CI: 1.4, 2.0; all odds ratios age- and sex-adjusted). Results were similar for high IHS scores (>1.25). Stratification by age and sex showed that most of the association with snoring (but not sleepiness) derived from boys <8 years old. CONCLUSIONS: Inattention and hyperactivity among general pediatric patients are associated with increased daytime sleepiness and---especially in young boys---snoring and other symptoms of SDB. If sleepiness and SDB do influence daytime behavior, the current results suggest a major public health impact.

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  • Sleep-disordered breathing (SDB) has been consistently associated with neurobehavioral and neurocognitive deficits, including inattentive or ADHD-like symptoms.

    “SDB has been consistently associated with neurobehavioral and neurocognitive deficits, including inattentive or ADHD-like symptoms (Beebe 2006; Beebe et al. 2004; Chervin et al. 2002, 2012; Gottlieb et al. 2003; Lal et al. 2012; O’Brien 2009; Owens 2008; Rosen et al. 2004; Soylu et al. 2013; Suratt et al. 2011).”

    From Associations of sleep disturbance with ADHD: implications for treatment (2015) · cites this paper as Chervin et al. 2002

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Authors
Chervin, R. D., Archbold, K. H., Dillon, J. E., Panahi, P., Pituch, K. J., Dahl, R. E., & Guilleminault, C.
Affiliations
  • University of Michigan (US)
  • University of Pittsburgh (US)
  • Stanford University (US)
ORCID
Venue
PEDIATRICS
Publisher
American Academy of Pediatrics (AAP)
Published
2002-03-01
Volume
109
Issue
3
Pages
449-456
ISSN
  • 0031-4005 (ISSN-L)
  • 1098-4275
DOI
10.1542/peds.109.3.449
OpenAlex
W2075082585
Cited by
538
References
51
Citations by year
2026: 3 · 2025: 10 · 2024: 8 · 2023: 11 · 2022: 12 · 2021: 13 · 2020: 14 · 2019: 18 · 2018: 13 · 2017: 20 · 2016: 14 · 2015: 21 · 2014: 29 · 2013: 30 · 2012: 26
FWCI
18.69
Type
journal article
Language
en
Open access
closed
Locations
  • PEDIATRICS (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • University of Michigan
  • National Institute of Neurological Disorders and Stroke (K02 NS02009, K02NS002009)
  • National Center for Research Resources (M-01RR00042, M01RR000042)
  • NIH Clinical Center
Topics
  • Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
Keywords
sleep-disordered breathing, snoring, inattention, hyperactivity, sleepiness, children, habitual snoring, Pediatric Sleep Questionnaire, Conners' Parent Rating Scale, sex differences, age differences, pediatric sleep medicine, daytime sleepiness, attention deficit hyperactivity disorder
MeSH terms
Adolescent, Attention Deficit Disorder with Hyperactivity, Child, Child, Preschool, Cross-Sectional Studies, Female, Humans, Disorders of Excessive Somnolence, Male, Surveys and Questionnaires, Sex Factors, Sleep Apnea Syndromes, Snoring, Logistic Models, Odds Ratio

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