title: Pediatric sleep disorders and special educational need at 8 years: a population-based cohort study.
abstract: OBJECTIVE
  To examine associations between sleep-disordered breathing (SDB) and behavioral sleep problems (BSPs) through 5 years of age and special educational need (SEN) at 8 years.
  
  
  METHODS
  Parents in the Avon Longitudinal Study of Parents and Children reported on children's snoring, witnessed apnea, and mouth-breathing at 6, 18, 30, 42, and 57 months, from which SDB symptom trajectories, or clusters, were derived. BSPs were based on report of ≥ 5 of 7 sleep behaviors at each of the 18-, 30-, 42-, and 57-month questionnaires. Parent report of SEN (yes/no) at 8 years was available for 11049 children with SDB data and 11467 children with BSP data. Multivariable logistic regression models were used to predict SEN outcome by SDB cluster and by cumulative report of SEN.
  
  
  RESULTS
  Controlling for 16 putative confounders, previous history of SDB and BSPs was significantly associated with an SEN. BSPs were associated with a 7% increased odds of SEN (95% confidence interval [CI] 1.01-1.15), for each ∼1-year interval at which a BSP was reported. SDB, overall, was associated with a near 40% increased odds of SEN (95% CI 1.18-1.62). Children in the worst symptom cluster were 60% more likely to have an SEN (95% CI 1.23-2.08).
  
  
  CONCLUSIONS
  In this population-based longitudinal study, history of either SDB or BSPs in the first 5 years of life was associated with increased likelihood of SEN at 8 years of age. Findings highlight the need for pediatric sleep disorder screening by early interventionists, early childhood educators, and health professionals.
authors.affiliation: Department of Family Medicine, Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY 10461, USA. Karen.bonuck@einstein.yu.edu
authors.forename: Karen
authors.initials: K
authors.lastname: Bonuck
authors.forename: Trupti
authors.initials: T
authors.lastname: Rao
authors.forename: Linzhi
authors.initials: L
authors.lastname: Xu
mesh_terms: D002648:Child; D002653:Child Behavior Disorders / Q000209:etiology; D002675:Child, Preschool; D015331:Cohort Studies; D003147:Communication Disorders / Q000209:etiology; D002658:Developmental Disabilities / Q000209:etiology; D004519:Education, Special / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D015999:Multivariate Analysis; D011446:Prospective Studies; D012891:Sleep Apnea Syndromes / Q000150:complications; D012893:Sleep Wake Disorders / Q000150:complications