School performance, race, and other correlates of sleep-disordered breathing in children.
ABSTRACT Childhood sleep-disordered breathing (SDB) has been associated with poor school performance. Both problems are common among African-American (AA) children, but potential confounders such as low socioeconomic status (SES) and obesity have not been well studied.
Children in second and fifth grades at six urban elementary schools were evaluated by teachers' ratings and year-end reading and math assessments. Risk for SDB was assessed with the validated parental Pediatric Sleep Questionnaire, and SES by qualification for school lunch assistance.
Among 146 children whose parents completed surveys, risk for SDB was associated with AA race, low SES, and poor teacher ratings (P<0.01), but not assessment scores (P>0.1). In multiple regression models, poor school performance was consistently and independently predicted by low SES (P<0.01) but not by AA race or SDB risk. Risk for SDB was associated with low SES before, but not after body mass index (BMI) was taken into account.
The SDB symptoms, AA race, and low SES all vary to some extent with poor school performance, but the only consistent and independent covariate of performance is SES. Risk for SDB is associated with low SES, perhaps because of a third variable, namely high BMI.
SourceAvailable from: Masaya Tachibana[Show abstract] [Hide abstract]
ABSTRACT: We aimed to present psychometric properties and describe the score distributions of the Japanese Sleep Questionnaire for Preschoolers (JSQ-P), a guardian-reported survey questionnaire for assessing sleep disturbances and problematic sleep habits among preschool children. Guardians of 2998 toddlers in three communities and guardians of 102 patients diagnosed with sleep disorders in two clinics completed the JSQ-P. Exploratory factor analysis (EFA) revealed the 10 domains of the JSQ-P to be similar to our previous small-scale study and confirmed the robustness of the JSQ-P. The JSQ-P showed acceptable internal consistency; α coefficients ranged from 0.622 (insufficient sleep) to 0.912 (restless legs syndrome [RLS], motor) for the community sample and 0.696 (insufficient sleep) to 0.959 (RLS, motor) for the clinical sample. The score differentiations between the community and clinical samples associated with RLS, obstructive sleep apnea syndrome (OSAS), morning symptoms, parasomnias, excessive daytime sleepiness, and daytime behaviors were demonstrated in our study. The distributions of percentile T scores for each subscale and age and gender differentiation of scores also were evaluated. We confirmed that the JSQ-P is a valid and reliable instrument to evaluate Japanese sleep habits using a large population-based sample. The JSQ-P may be useful in both clinical and academic settings.Sleep Medicine 12/2013; DOI:10.1016/j.sleep.2013.05.020 · 3.10 Impact Factor
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ABSTRACT: Study Objectives: To evaluate a novel sleep education program for low-income preschool children and their families. Design: Randomized trial of an educational intervention. Setting: Community-based. Participants: Head Start preschool families (n = 152) in greater Lansing and Detroit, Michigan. Interventions: Classrooms or Head Start sites were randomized to an intervention group (prompt intervention) versus a control group (delayed intervention). Parents attended a one-time, 45-min sleep education program and preschoolers received 2 w (320 total min) of classroom sleep curriculum. Measurements: Parent knowledge, attitudes, self-efficacy, and beliefs were assessed as the primary outcomes just before the 45-min sleep intervention, immediately postintervention, and approximately 1 mo postintervention. Parents reported their child's bedtimes and wake times on 7-day sleep diaries at baseline and at 1-mo follow-up. Average weeknight sleep durations and bedtimes served as secondary outcomes. Results: Linear mixed models showed a time x treatment effect for parents' knowledge, attitudes, and self-efficacy (each P < 0.05) but not beliefs. These improvements were found immediately postintervention but were not retained at 1-mo follow-up. Children in the intervention group improved their weeknight sleep duration at 1-mo follow-up by 30 min (11.0 +/- 0.9 h vs. 10.5 +/- 1.0 hours at baseline) compared to controls (10.4 +/- 0.9 h versus 10.5 +/- 0.9 h at baseline) (P = 0.04 for difference between groups). Children did not show statistically significant improvements in bedtime. Conclusions: Educational interventions in early childhood can have an effect on parents' sleep knowledge, attitudes, and self-efficacy, and on children's sleep behavior. However, repeated exposure to the new information may be important for parents as well as their children.Sleep 06/2014; 37(6):1117-25. DOI:10.5665/sleep.3774 · 5.06 Impact Factor
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ABSTRACT: Objective Sleep problems may affect daytime performance. Thus, the prevalence of sleep problems and their associations with poor academic performance in a cross-sectional study performed in 27 primary schools in Hannover, Germany, were investigated. Methods Sleep problems (e.g., sleep onset delays, night awakenings, sleepwalking, nightmares, and bedwetting) were examined by parental and children’s questionnaires. Poor academic performance, defined as grade 4 or more on a 6-point scale, or requirement for additional lessons in mathematics, science, reading, spelling, or handwriting was assessed using grades from the last term’s school report forms. Results Of 1,144 children enrolled (mean age 9.6 years, 51% males), 760 (66.4%) had sleep problems reported by their parents, with sleep onset delays having the highest prevalence (prevalence 49.1%, 95% confidence interval (CI) 46.1–51.9). Children reported sleep problems more frequently than their parents. Significant associations with academic performance were found for night awakenings and nightmares; however, clear dose–response relationships were only found for nightmares. Children who “often” had nightmares (n = 24) were more likely to have poor academic performance in mathematics (odds ratio 5.2, 95% CI 1.6–17.1), science (6.8, 95% CI 1.4–32.1), and spelling (7.5, 95% CI 2.3–24.9). Conclusion Sleep problems are common in primary school children. Among these, nightmares may have a negative impact on academic performance.Somnologie - Schlafforschung und Schlafmedizin 12/2011; 15(4). DOI:10.1007/s11818-011-0535-8