Prevalence and risk factors of excessive daytime sleepiness in a community sample of young children: the role of obesity, asthma, anxiety/depression, and sleep

• Published in: Sleep (New York, N.Y.) Vol. 34; no. 4; pp. 503 - 507
• Main Authors: Calhoun, Susan L, Vgontzas, Alexandros N, Fernandez-Mendoza, Julio, Mayes, Susan D, Tsaoussoglou, Marina, Basta, Maria, Bixler, Edward O
• Format: Journal Article
• Language: English
• Published: United States Associated Professional Sleep Societies, LLC 01-04-2011
• Subjects: Anxiety - complications; Asthma - complications; Chi-Square Distribution; Child; Cross-Sectional Studies; Depression - complications; Disorders of Excessive Somnolence - epidemiology; Disorders of Excessive Somnolence - etiology; Female; Humans; Logistic Models; Male; Multivariate Analysis; Obesity - complications; Odds Ratio; Polysomnography; Prevalence; Prevalence and Risk Factor of EDS in Young Children; Risk Factors; Sleep; Sleep Wake Disorders - complications; Surveys and Questionnaires; Waist Circumference; excessive daytime sleepiness; Children; anxiety/depression; obesity
• ISSN: 0161-8105; 1550-9109
• DOI: 10.1093/sleep/34.4.503

We investigated the prevalence and association of excessive daytime sleepiness (EDS) with a wide range of factors (e.g., medical complaints, obesity, objective sleep [including sleep disordered breathing], and parent-reported anxiety/depression and sleep difficulties) in a large general population sample of children. Few studies have researched the prevalence and predictors of EDS in young children, none in a general population sample of children, and the results are inconsistent.
Cross-sectional
Population -based.
508 school-aged children from the general population.
N/A.
Children underwent a 9-hour polysomnogram (PSG), physical exam, and parent completed health, sleep and psychological questionnaires. Children were divided into 2 groups: those with and without parent reported EDS. The prevalence of subjective EDS was approximately 15%. Significant univariate relationships were found between children with EDS and BMI percentile, waist circumference, heartburn, asthma, and parent reported anxiety/depression, and sleep difficulties. The strongest predictors of EDS were waist circumference, asthma, and parent-reported symptoms of anxiety/depression and trouble falling asleep. All PSG sleep variables including apnea/hypopnea index, caffeine consumption, and allergies were not significantly related to EDS.
It appears that the presence of EDS is more strongly associated with obesity, asthma, parent reported anxiety/depression, and trouble falling asleep than with sleep disordered breathing (SDB) or objective sleep disruption per se. Our findings suggest that children with EDS should be thoroughly assessed for anxiety/depression, nocturnal sleep difficulties, asthma, obesity, and other metabolic factors, whereas objective sleep findings may not be as clinically useful.