title: Prevalence and risk factors of excessive daytime sleepiness in a community sample of young children: the role of obesity, asthma, anxiety/depression, and sleep.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Cross-sectional
  
  
  METHODS
  Population -based.
  
  
  METHODS
  508 school-aged children from the general population.
  
  
  METHODS
  N/A.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors: Sleep Research and Treatment Center, Pennsylvania State University College of Medicine, Hershey, PA 17033, USA. scalhoun@psu.edu
authors: Susan L
authors: SL
authors: Calhoun
authors: Alexandros N
authors: AN
authors: Vgontzas
authors: Julio
authors: J
authors: Fernandez-Mendoza
authors: Susan D
authors: SD
authors: Mayes
authors: Marina
authors: M
authors: Tsaoussoglou
authors: Maria
authors: M
authors: Basta
authors: Edward O
authors: EO
authors: Bixler
mesh_terms: D001007:Anxiety / Q000150:complications*; D001249:Asthma / Q000150:complications*; D016009:Chi-Square Distribution; D002648:Child; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications*; D006970:Disorders of Excessive Somnolence / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications*; D016017:Odds Ratio; D017286:Polysomnography; D015995:Prevalence; D012307:Risk Factors; D012890:Sleep; D012893:Sleep Wake Disorders / Q000150:complications*; D011795:Surveys and Questionnaires; D055105:Waist Circumference