Children with sleep-related breathing problems (such as snoring or apnea) frequently have concurrent behavioral sleep problems (such as waking repeatedly) - and vice versa, according to research led by a scientist at Albert Einstein College of Medicine of Yeshiva University. However, children with one type of sleep problem are not routinely evaluated and treated for the other. The findings suggest that pediatricians, respiratory specialists and sleep medicine specialists should work together whenever a sleep problem is suspected. The study was published December 4 in the online edition of Behavioral Sleep Medicine.
"Our findings should raise awareness among parents and physicians that if a child is sleeping poorly, they should delve deeper to see if there is an unrecognized respiratory-related sleep problem," said senior author Karen Bonuck, Ph.D., professor of family and social medicine and of obstetrics & gynecology and women's health at Einstein. "The best way to make sure this happens is by taking an interdisciplinary approach to the care of these children."
According to Dr. Bonuck, little was known about the co-occurrence of behavioral sleep problems and sleep-disordered breathing (SDB). She and her colleagues carried out this study to find the prevalence and duration of behavioral sleep problems and of SDB - and the rate at which they co-occur - in a large, population-based sample of children (aged 18 months to nearly 5 years). The researchers analyzed data on more than 11,000 children enrolled in the Avon Longitudinal Study of Parents and Children, a project based in the United Kingdom.
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.