Aggressive behavior, bullying, snoring, and sleepiness in schoolchildren

O’Brien LM, Lucas NH, Felt BT, Hoban TF, Ruzicka DL, Jordan R, Guire K, Chervin RD.
Source
Sleep Disorders Center, Department of Neurology, University of Michigan, Ann Arbor, MI, United States; Department of Oral and Maxillofacial Surgery, University of Michigan, Ann Arbor, MI, United States.
Abstract
BACKGROUND:
To assess whether urban schoolchildren with aggressive behavior are more likely than peers to have symptoms suggestive of sleep-disordered breathing.

METHODS:
Cross-sectional survey of sleep and behavior in schoolchildren. Validated screening assessments for conduct problems (Connor’s rating scale), bullying behavior, and sleep-disordered breathing (pediatric sleep questionnaire) were completed by parents. Teachers completed Connor’s teacher rating scale.

RESULTS:
Among 341 subjects (51% female), 110 (32%) were rated by a parent or teacher as having a conduct problem (T-score ⩾65) and 78 (23%) had symptoms suggestive of sleep-disordered breathing. Children with conduct problems, bullying, or discipline referrals, in comparison to non-aggressive peers, more often had symptoms suggestive of sleep-disordered breathing (each p<0.05). Children with vs. without conduct problems were more likely to snore habitually (p<0.5). However, a sleepiness subscale alone, and not a snoring subscale, predicted conduct problems after accounting for age, gender, a measure of socioeconomic status, and stimulant use.

CONCLUSIONS:
Urban schoolchildren with aggressive behaviors may have symptoms of sleep-disordered breathing with disproportionate frequency. Sleepiness may impair emotional regulation necessary to control aggression.

Sleep Med. 2011 May 25

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