title: Sleep disordered breathing and daytime sleepiness are associated with poor academic performance in teenagers. A study using the Pediatric Daytime Sleepiness Scale (PDSS).
abstract: OBJECTIVE
  Inadequate sleep and sleep disordered breathing (SDB) can impair learning skills. Questionnaires used to evaluate sleepiness in adults are usually inadequate for adolescents. We conducted a study to evaluate the performance of a Spanish version of the Pediatric Daytime Sleepiness Scale (PDSS) and to assess the impact of sleepiness and SDB on academic performance.
  
  
  METHODS
  A cross-sectional survey of students from 7 schools in 4 cities of Argentina.
  
  
  METHODS
  A questionnaire with a Spanish version of the PDSS was used. Questions on the occurrence of snoring and witnessed apneas were answered by the parents. Mathematics and language grades were used as indicators of academic performance.
  
  
  METHODS
  The sample included 2,884 students (50% males; age: 13.3 +/- 1.5 years)
  
  
  RESULTS
  Response rate was 85%; 678 cases were excluded due to missing data. Half the students slept <9 h per night on weekdays. The mean PDSS value was 15.74 +/- 5.93. Parental reporting of snoring occurred in 511 subjects (23%); snoring was occasional in 14% and frequent in 9%. Apneas were witnessed in 237 cases (11%), being frequent in 4% and occasional in 7%. Frequent snorers had higher mean PDSS scores than occasional or nonsnorers (18 +/- 5, 15.7 +/- 6 and 15.5 +/- 6, respectively; P < 0.001). Reported snoring or apneas and the PDSS were significant univariate predictors of failure and remained significant in multivariate logistic regression analysis after adjusting for age, sex, body mass index, specific school attended, and sleep habits.
  
  
  CONCLUSIONS
  Insufficient hours of sleep were prevalent in this population. The Spanish version of the PDSS was a reliable tool in middle-school-aged children. Reports of snoring or witnessed apneas and daytime sleepiness as measured by PDSS were independent predictors of poor academic performance.
authors.affiliation: Pulmonary Division, Department of Internal Medicine, Hospital Universitario Austral, Buenos Aires, Argentina. dperez@cas.austral.edu.ar
authors.forename: Daniel
authors.initials: D
authors.lastname: Perez-Chada
authors.forename: Santiago
authors.initials: S
authors.lastname: Perez-Lloret
authors.forename: Alejandro J
authors.initials: AJ
authors.lastname: Videla
authors.forename: Daniel
authors.initials: D
authors.lastname: Cardinali
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Bergna
authors.forename: Mariano
authors.initials: M
authors.lastname: Fernández-Acquier
authors.forename: Luis
authors.initials: L
authors.lastname: Larrateguy
authors.forename: Gustavo E
authors.initials: GE
authors.lastname: Zabert
authors.forename: Christopher
authors.initials: C
authors.lastname: Drake
mesh_terms: D000293:Adolescent; D001118:Argentina; D002648:Child; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D006970:Disorders of Excessive Somnolence / Q000175:diagnosis / Q000453:epidemiology*; D004522:Educational Status; D005260:Female; D006306:Health Surveys; D006801:Humans; D007859:Learning Disabilities / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000453:epidemiology*; D012892:Sleep Deprivation / Q000175:diagnosis / Q000453:epidemiology*; D012913:Snoring / Q000175:diagnosis / Q000453:epidemiology*