Sleep Disordered Breathing in Early Childhood: Quality of Life for Children and Families

Study Questions:

Does health-related quality of life (QOL) differ among preschool children with sleep disordered breathing (SDB) and their families compared with nonsnoring control patients in the community?

Methods:

A clinical sample of preschool children (3-5 years old) with SDB diagnosed by gold standard polysomnography (PSG) was recruited from the Melbourne Children’s Sleep Centre between July 2008 and May 2011. Nonsnoring control children were recruited from the community. All children underwent standard pediatric overnight clinical PSG. Parents (predominantly mothers) completed demographic and behavioral questionnaires on the night of the study. QOL and parenting stress questionnaires were completed by parents during home visits conducted 1-3 weeks after the PSG study, at which time cognitive assessments were performed. Sleep diaries were completed by parents during the week prior to each home visit.

Results:

A total of 160 clinically referred children were recruited for the project. Of these, 115 (56 primary snoring, 35 mild obstructive sleep apnea, 24 moderate/severe obstructive sleep apnea) participated in both the PSG and home assessments and had adequate PSG data for analysis (>4 hours of sleep overnight to enable clinical diagnosis). Of 42 nonsnoring children recruited, 38 met control group criteria and had adequate data for inclusion. Children and families in the primary snoring and mild obstructive sleep apnea groups had consistently poorer QOL than control children (both p < 0.05-0.001), based on parent ratings, and parents of children with primary snoring had elevated stress ratings relative to control children (p < 0.05-0.001). The moderate/severe obstructive sleep apnea group differed from the control group on select measures of parent and family QOL (worry, p < 0.001 and total family impact, p < 0.05).

Conclusions:

The investigators concluded that SDB is associated with reduced QOL in preschool children and their families.

Perspective:

Information on sleep characteristics is limited among children. Understanding the impact of SDB will allow for the successful development of interventions to improve sleep.

Clinical Topics: Congenital Heart Disease and Pediatric Cardiology, Heart Failure and Cardiomyopathies, CHD & Pediatrics and Quality Improvement, Sleep Apnea

Keywords: Child, Snoring, Polysomnography, Pediatrics, Mothers, Questionnaires, Sleep Apnea Syndromes


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