Sleep architecture and behavioral abnormalities in children and adolescents

Gloria Reeves, Carol Blaisdell, Manana Lapidus, Patricia Langenberg, Maya Ramagopal, Johanna Cabassa, Mary Beth Bollinger, Gagan Virk Nijjar, Bruno Anthony, Thomas Achenbach, Teodor T. Postolache

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Objective: To investigate the association between sleep disordered breathing (SDB) and parent report of attention and behavioral problems in children, as well as the association between sleep stage duration and measures of child functioning in a clinically referred sample. Methods: A chart review was conducted of 95 children with clinical history of SDB who completed an overnight polysomnography study in a pediatric sleep laboratory. Child functioning was assessed at the time of the sleep study by parent report on the Child Behavior Checklist (CBCL). The apnea hypopnea index was used as a measure of SDB severity. Results: The apnea hypopnea index was associated with externalizing behavior, but not attention problems on the CBCL. In children 2-3 years old, stage 4 sleep duration was associated with externalizing behavior. In children 4-16 years old, REM sleep duration was associated with externalizing behavior. Conclusions: Children with increased SDB severity may be at greater risk for behavioral problems. Differences between the association of sleep stages and externalizing behavior in toddlers compared with older children suggests possible developmental differences in the association between sleep and behavior.

Original languageEnglish (US)
Pages (from-to)535-545
Number of pages11
JournalInternational Journal of Adolescent Medicine and Health
Issue number4
StatePublished - 2010

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Public Health, Environmental and Occupational Health


  • Apnea
  • Child behavior checklist
  • Pediatric behavior problems
  • Sleep disordered breathing


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