title: Aggressive behavior, bullying, snoring, and sleepiness in schoolchildren.
abstract: BACKGROUND
  To assess whether urban schoolchildren with aggressive behavior are more likely than peers to have symptoms suggestive of sleep-disordered breathing.
  
  
  METHODS
  Cross-sectional survey of sleep and behavior in schoolchildren. Validated screening assessments for conduct problems (Connor's rating scale), bullying behavior, and sleep-disordered breathing (pediatric sleep questionnaire) were completed by parents. Teachers completed Connor's teacher rating scale.
  
  
  RESULTS
  Among 341 subjects (51% female), 110 (32%) were rated by a parent or teacher as having a conduct problem (T-score ⩾65) and 78 (23%) had symptoms suggestive of sleep-disordered breathing. Children with conduct problems, bullying, or discipline referrals, in comparison to non-aggressive peers, more often had symptoms suggestive of sleep-disordered breathing (each p<0.05). Children with vs. without conduct problems were more likely to snore habitually (p<0.5). However, a sleepiness subscale alone, and not a snoring subscale, predicted conduct problems after accounting for age, gender, a measure of socioeconomic status, and stimulant use.
  
  
  CONCLUSIONS
  Urban schoolchildren with aggressive behaviors may have symptoms of sleep-disordered breathing with disproportionate frequency. Sleepiness may impair emotional regulation necessary to control aggression.
authors.affiliation: Sleep Disorders Center, Department of Neurology, University of Michigan, Ann Arbor, MI 48109-0845, USA. louiseo@med.umich.edu
authors.forename: Louise M
authors.initials: LM
authors.lastname: O'Brien
authors.forename: Neali H
authors.initials: NH
authors.lastname: Lucas
authors.forename: Barbara T
authors.initials: BT
authors.lastname: Felt
authors.forename: Timothy F
authors.initials: TF
authors.lastname: Hoban
authors.forename: Deborah L
authors.initials: DL
authors.lastname: Ruzicka
authors.forename: Ruth
authors.initials: R
authors.lastname: Jordan
authors.forename: Kenneth
authors.initials: K
authors.lastname: Guire
authors.forename: Ronald D
authors.initials: RD
authors.lastname: Chervin
mesh_terms: D000374:Aggression / Q000502:physiology* / Q000523:psychology; D058445:Bullying / Q000502:physiology*; D002648:Child; D002653:Child Behavior Disorders / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D003430:Cross-Sectional Studies; D006970:Disorders of Excessive Somnolence / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D004644:Emotions / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D012913:Snoring / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D011795:Surveys and Questionnaires