Sleep hygiene and problem behaviors in snoring and non-snoring school-age children

Abstract

Objectives: The effects of sleep-disordered breathing, sleep restriction, dyssomnias, and parasomnias on daytime behavior in children have been previously assessed. However, the potential relationship(s) between sleep hygiene and children's daytime behavior remain to be explored. The primary goal of this study was to investigate the relationship between sleep hygiene and problematic behaviors in non-snoring and habitually snoring children.

Methods: Parents of 100 5- to 8-year-old children who were reported to snore "frequently" to "almost always," and of 71 age-, gender-, and ethnicity-matched children who were reported to never snore participated in this study. As part of a larger, ongoing study, children underwent nocturnal polysomnography and parents were asked to complete the Children's Sleep Hygiene Scale (CSHS) and the Conners' Parent Rating Scales-Revised (CPRS-R:L).

Results: In the snoring group, strong negative correlations (r=-.39, p<.001) between the CSHS overall sleep hygiene score and the CPRS-R:L DSM-IV total scores emerged. Additionally, several subscales of the CSHS and CPRS-R:L were significantly correlated (p-values from <.000 to .004) in snoring children. No significant correlations were observed between the CSHS and the CPRS-R:L in the non-snoring children.

Conclusions: Parental reports of behavioral patterns in snoring children indicate that poorer sleep hygiene is more likely to be associated with behavior problems, including hyperactivity, impulsivity, and oppositional behavior. In contrast, no significant relationships between sleep hygiene and problem behaviors emerged among non-snoring children. These results indicate that children at risk for sleep disordered breathing are susceptible to daytime behavior impairments when concurrently coupled with poor sleep hygiene practices.

Figure 1

Scatterplots of various Children’s Sleep Hygiene Scale (CSHS) and the Conners’ Parent Rating Scales-Revised (CPRS-R:L) measures against sleep hygiene in habitually snoring and non snoring children

Figure 1

Scatterplots of various Children’s Sleep Hygiene Scale (CSHS) and the Conners’ Parent Rating Scales-Revised (CPRS-R:L) measures against sleep hygiene in habitually snoring and non snoring children

Figure 2

Mediation model linking snoring to the association between global sleep hygiene (CSHS total score) and behavioral dysregulation.