Factors affecting sleep disturbances in children and adolescents

Objective: To determine factors affecting sleep disturbances in children. Background: Factors affecting sleep disturbances have been studied extensively in adults, but relatively few studies have been done in children. Methods: As part of the twelfth survey of the Tucson Epidemiologic Study of Obstructive Airways Disease (TESOAD, 1991-1992), children, ages 3-14, of adult cohort members were administered a health questionnaire which contained items related to sleep problems as well as items related to respiratory diseases and symptoms. Participants were classified as having sleep disturbances if they reported disorders of initiating and maintaining sleep (DIMS), excessive daytime sleepiness (EDS) or snoring. Potential factors affecting sleep included age, gender, obesity, asthma, other bronchial problems, cough and sputum production, wheezing and rhinitis. Results: The overall prevalence rates were 16.8, 4 and 22.9% for DIMS, EDS, and snoring, respectively. We found a significantly higher prevalence of DIMS in 11-14-year-old girls (30.4%) and snoring (32.3%) in 3-6-year-old boys. Certain respiratory factors were more prevalent in children with sleep disturbances. Multivariate analysis revealed that risk factors for DIMS included female gender, age 11-14 and wheezing. The risk for EDS was increased in those children with cough and sputum production. Cough and sputum production also were risk factors for snoring as was rhinitis and age 3-6. Conclusions: We conclude that in children as in adults, respiratory symptoms are associated with sleep disturbances. Further, the increased insomnia seen in adult women may begin in early adolescence.