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VOLUME 36, ISSUE 04

RISK OF BEHAVIORAL DIFFICULTIES IN YOUTH WITH SDB
Risk of Behavioral and Adaptive Functioning Difficulties in Youth with Previous and Current Sleep Disordered Breathing

http://dx.doi.org/10.5665/sleep.2536

Michelle M. Perfect, PhD1; Kristen Archbold, PhD2; James L. Goodwin, PhD3; Deborah Levine-Donnerstein, PhD4; Stuart F. Quan, MD3,5

1Department of Disability and Psychoeducational Studies, University of Arizona, Tucson, AZ; 2College of Nursing, University of Arizona, Tucson, AZ; 3Arizona Respiratory Center, Department of Medicine, University of Arizona College of Medicine, Tucson, AZ; 4Department of Educational Psychology, University of Arizona, Tucson, AZ; 5Division of Sleep Medicine, Harvard Medical School, Boston, MA



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Objectives:

To examine the rates of behavioral and adaptive functioning difficulties among youth who never had sleep disordered breathing (SDB), had remitted SDB, had incident SDB, or had persistent SDB; and to determine if there were increased odds of behavioral difficulties among youth with varying SDB histories relative to those who never had SDB.

Methods:

263 youth had valid polysomnography and neurobehavioral data at two time points approximately 5 years apart from the prospective Tucson Children's Assessment of Sleep Apnea study. Primary outcomes were the Behavior Assessment Scale for Children-2nd Edition Parent Report Form (BASC-PRF) and Self-Report of Personality (SRP), and the Adaptive Behavior Assessment System-2nd Edition (ABAS-2).

Results:

Compared to those who never had SDB, individuals with persistent SDB had significant odds and met more cutoff scores on the BASC-2-PRF Externalizing Problems Composite (odds ratio [OR] 3.29; 8.92% vs. 35.3%), Behavioral Symptoms Index (OR 6.82; 7.4% vs. 35.3%) and Hyperactivity subscale (OR 6.82; 11.1% vs. 41.2%). Similarly, greater difficulties was seen for the group with persistent SDB (relative to never) on the ABAS-2 Social Domain (OR 3.39; 22% vs. 50%), and Communication (OR 4.26; 15% vs. 42.9%) and Self-Care subscales (OR = 2.97; 25.2% vs. 50%). Relative to youth who never had SDB, youth who developed SDB at Time 2 had compromised adaptive skills as evidenced by the BASC-2 PRF Adaptive Behavior Composite (OR 3.34; 15.6% vs. 38.1%) and the ABAS-2 General Adaptive Composite (OR 2.83; 20.5% vs. 42.1%).

Conclusions:

Youth with current SDB exhibited hyperactivity, attention problems, aggressivity, lower social competency, poorer communication, and/or diminished adaptive skills.

Citation:

Perfect MM; Archbold K; Goodwin JL; Levine-Donnerstein D; Quan SF. Risk of behavioral and adaptive functioning difficulties in youth with previous and current sleep disordered breathing. SLEEP 2013;36(4):517-525.

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