Sleep disordered breathing in children: which symptoms do parents consider a problem?

Abstract

Study Objective: Parents tend to under-report symptoms suggestive of sleep disordered breathing (SDB) at medical consultation. It is thought that a contributing factor may be whether parents view SDB symptoms as a problem. The aim of the study was to examine to what extent parents view SDB symptoms as a problem in children recruited from the general community and especially in children who currently have symptoms suggestive of SDB. Methods: Parents of 1639 children aged 5-10 y attending middle school in South Australia completed a questionnaire which included demographics and assessed the frequency over the previous school week of 32 sleep habits including six SDB sleep habit items. The sample was restricted to typically developing children and excluded children with medical problems likely to impact SDB. The final sample included 1610 children without a prior diagnosis of SDB and 29 with a prior diagnosis and/or treatment of SDB. Parents were asked to rate children's sleep habits using a 4-pt scale (never, rarely, sometimes and usually) and if the sleep habit was perceived to be a problem (yes/no). Children who sometimes or usually reported a sleep habit item were labelled as symptomatic. Results: Parents of children with, compared to those without, a prior diagnosis of SDB, were more likely to report the presence of SDB symptoms which were more frequently viewed as a problem. In children without a prior diagnosis of SDB, parents of symptomatic children viewed most SDB symptoms as a problem ranging from 91% for apnoea, 63% snorted/gasped, 63% watched child breathing at night, 58% snored loudly, 49% snored to 32% breathing heavily at night. Additional analyses in the combined sample revealed that a prior diagnosis of SDB, gender, socioeconomic status and ethnicity were weak predictors of whether parents viewed SDB sleep symptoms as a problem. Conclusion: In children with symptoms suggestive of SDB, most parents viewed most SDB symptoms as a problem especially apnoea. The high frequency is contrary to that expected given the under-reporting of SDB symptoms at medical consultation. This suggests that additional factors other than whether parents consider SDB symptoms as a problem might better explain the under-reporting of SDB symptoms at medical consultation. Given the important impact on child health and medical service provision, future studies examining the factors that prompt parents to discuss SDB symptoms at medical consultation are warranted.