Original Articles
Symptoms of sleep disturbances among children at two general pediatric clinics,☆☆

Presented in part at meetings of the Midwest Nursing Research Society, April 3, 2000, Dearborn, Michigan, and the Association of Professional Sleep Societies, June 19, 2000, Las Vegas, Nevada.
https://doi.org/10.1067/mpd.2002.119990Get rights and content

Abstract

Objective: We assessed the frequency of childhood sleep problems at 2 general pediatric clinics. Study design: Parents of 1038 unselected children (554 boys) aged 2.0 to 13.9 years completed a validated Pediatric Sleep Questionnaire while waiting for appointments. Results: Habitual snoring was reported in 176 (17%) of the children. Criterion scores suggestive of sleep-disordered breathing were found in 115 (11%) of the children, in 29% of children at the clinic for neurologic indications, and in 21% of children at the clinic for noninfectious respiratory indications. Insomnia (ie, unrefreshing sleep or difficulty with sleep onset, sleep maintenance, or early morning awakening from sleep) was reported in 430 (41%) of the children; ≥2 symptoms were present in 191 (18%) of the children. Excessive daytime sleepiness was suggested in 148 (14%) of the children, and 390 (38%) had symptoms of sleep terrors, sleepwalking, or nocturnal bruxism. Conclusions: Sleep problems such as sleep-disordered breathing, insomnia, excessive sleepiness, and parasomnias are frequent among children seen at general pediatric practices. (J Pediatr 2002;140:97-102)

Section snippets

Patients

Between February 5, 1998, and May 1, 2000, parents and children (aged 2.0-13.9 years) were recruited while they waited for a general pediatrics appointment. Research assistants attempted to approach all child-parent pairs at the clinics on designated days. Inclusion criteria, designed to impose few restrictions and maximize generalizability of findings, were (1) the presence of a parent or guardian who was able to read and write, (2) the absence of any current treatment or previous surgery for

Patients

Parents of approximately 1400 children were approached and 1038 questionnaires were completed: 328 in the winter, 292 in the spring, 114 in the summer, and 304 in the fall. The mean subject age was 6.7 ± 3.2 years, 554 (53.4%) of the patients were boys, and 484 (46.6%) were girls. Reported racial and ethnic backgrounds were 606 (58.4%) white, 201 (19.4%) African American, 59 (5.7%) Asian-American, 16 (1.5%) Hispanic, 5 (0.5%) American Indian, and 151 (14.5%) other or unknown. Proportions of

Discussion

The results of this observational study of 1038 general pediatric outpatients suggest that several sleep-related problems are highly prevalent in this population. Published frequencies of childhood obstructive sleep apnea range from 1% to 3% but are largely based on questionnaire data7 or relatively insensitive recording techniques.4 No estimates of the number of children with upper airway resistance syndrome are available. The PSQ probably identified many children with each type of SDB,14 but

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    Supported by a grant from the NINDS No. K02-NS02009 (R.D.C.) and by the University of Michigan General Clinical Research Center (MOI-RR00042).

    ☆☆

    Reprint requests: Ronald D. Chervin, MD, MS, Michael S. Aldrich Sleep Disorders Laboratory, 8D8702 University Hospital, Box 0117, 1500 E Medical Center Dr, Ann Arbor, MI 48109-0117.

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