Prevalence and Determinants of Emotional and Behavioral Problems in Children with Sleep Disordered Breathing
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Date
2024-09-19
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Addis Ababa University
Abstract
Background: Sleep disordered breathing (SDB) is a condition characterized by episodes of complete or partial upper airway obstruction with the primary symptom of snoring. Few studies in Africa explored the burden of SDB in children. Literatures describe children suffer from behavioral problems and poor school performance as a consequence of SDB. Therefore, there is a need to conduct a study on preschool and early school age children to assess the prevalence and determinants of behavioral problems in children with sleep disordered breathing.
Method: An analytical cross-sectional study was conducted on children aged 2-18 years attending outpatient ear, nose, and throat clinics at three referral hospitals in Addis Ababa, Ethiopia from December 2023 up to June 2024 G.C. For data collection, we used a developed questionnaire to assess the socio-demographic and medical history of the child. Additionally, Pediatric sleep questionnaire and Strengths and Difficulties Questionnaire, previously validated questionnaires, were used to identify children with OSA and assess behavioral problems, respectively. Questionnaires were translated into local language “Amharic” and back-translated to validate the translation. Trained nurses filled out the questionnaires while interviewing the child’s parents or guardians. Data quality was regularly checked by the principal investigator. Ethical clearance was obtained from department of pediatrics and child health research and publication committee, college of health science, Addis Ababa university. The data was analyzed using SPSS version 25.
Result: Our study included 394 participants. The median age was 5 years (interquartile range (IQR) 4- 7 years. Our results showed 53.6% of children and adolescents with sleep disordered breathing had behavioral problems with a slightly raised, high, or very high total difficulties score. The most widely affected sub-domain was the emotional problems score (57.6%) followed by peer problems score (44.9%). Of the 394 study subjects, 40.9% had conduct problems, 35% had hyperactivity and 36% had lowered prosocial scores. Children in preschool and middle childhood years had increased odds of having raised hyperactivity scores along with those with indoor biomass fuel exposure. Lastly, lower prosocial scores were seen in male children and those with previously diagnosed neurologic problems.
Conclusions and recommendations: In conclusion, the burden of emotional and behavioral problems in children with SDB is significantly recognized in our study. Consequently, in the future, the need to explore the impact of SDB treatment on emotional and behavioral problems arises.
Key words: Obstructive sleep apnea, Sleep disordered breathing, hyperactivity
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Keywords
Obstructive sleep apnea Sleep disordered breathing hyperactivity