Risk of behavioral and adaptive functioning difficulties in youth with previous and current sleep disordered breathing

Objectives: To examine the rates of behavioral and adaptive functioning difficulties among youth who never had sleep disordered breathing (SDB), had remitted SDB, had incident SDB, or had persistent SDB; and to determine if there were increased odds of behavioral difficulties among youth with varying SDB histories relative to those who never had SDB. Methods: 263 youth had valid polysomnography and neurobehavioral data at two time points approximately 5 years apart from the prospective Tucson Children's Assessment of Sleep Apnea study. Primary outcomes were the Behavior Assessment Scale for Children-2nd Edition Parent Report Form (BASC-PRF) and Self-Report of Personality (SRP), and the Adaptive Behavior Assessment System-2^nd Edition (ABAS-2). Results: Compared to those who never had SDB, individuals with persistent SDB had significant odds and met more cutoff scores on the BASC- 2-PRF Externalizing Problems Composite (odds ratio [OR] 3.29; 8.92% vs. 35.3%), Behavioral Symptoms Index (OR 6.82; 7.4% vs. 35.3%) and Hyperactivity subscale (OR 6.82; 11.1% vs. 41.2%). Similarly, greater difficulties was seen for the group with persistent SDB (relative to never) on the ABAS-2 Social Domain (OR 3.39; 22% vs. 50%), and Communication (OR 4.26; 15% vs. 42.9%) and Self-Care subscales (OR = 2.97; 25.2% vs. 50%). Relative to youth who never had SDB, youth who developed SDB at Time 2 had compromised adaptive skills as evidenced by the BASC- 2 PRF Adaptive Behavior Composite (OR 3.34; 15.6% vs. 38.1%) and the ABAS-2 General Adaptive Composite (OR 2.83; 20.5% vs. 42.1%). Conclusions: Youth with current SDB exhibited hyperactivity, attention problems, aggressivity, lower social competency, poorer communication, and/or diminished adaptive skills.