Obstructive sleep apnea and snoring in Icelandic children : the five-to-fifteen questionnaire and school performance

Abstract

Sleep-disordered breathing (SDB), from reported snoring to obstructive sleep apnea (OSA), has been associated with emotional and behavioral problems in children, as well as academic decrements. This study examined reported snoring as well as objectively measured snoring and OSA in 112 children in Iceland (mean age = 11.8). Sleep measures were compared to participants´ emotional and behavioral outcomes using the Five-to-fifteen (FTF) questionnaire and academic records on a standardized national test. Subjects with reported SDB were matched with controls of the same age and gender, with no reported SDB. Snoring and apnea-hypopnea index (AHI) were measured with an overnight polysomnography (PSG) with audio. The results showed that boys were more likely to have objectively measured OSA, but no gender differences were found in parental reported SDB or objectively measured snoring. Scores on the FTF indicated poorer outcomes in children who had reported SDB then controls. Objective measures showed that children who snored or had OSA had worse outcomes in some areas, compared to controls. However, the differences were not as evident as for reported snoring. School performance did not differ in any of the comparisons. Correlations between objectively measured SDB indices and scores on the FTF resulted in poorer outcomes being related to a higher AHI and in some cases, a higher snoring percentage. These findings suggest that children with subjectively and objectively measured SDB have poorer emotional and behavioral outcomes than their peers. It is important that children with SDB symptoms receive clinical care to improve their daytime function.Keywords: obstructive sleep apnea, snoring, children, mental health, school performance.