Increased severity of sleep-disordered breathing is associated with insomnia and excessive somnolence in primary school children.
The aim of the study was to investigate the prevalence of difficulty with initiation or maintenance of sleep (DIMS) and excessive daytime sleepiness (EDS) in a general pediatric population, and to evaluate the relationship between these conditions and sleep-disordered breathing (SDB) symptom intensity.



This population-based cross-sectional study from 27 primary schools in a medium-sized city in Poland was based on use of a questionnaire regarding demographic data, symptoms of SDB, DIMS, and EDS. Data were collected between September and December 2014. In all, 2940 caregivers were recruited and were asked to fill-out questionnaires and written consent.



A total of 68% of the questionnaires (n = 1987) were returned and analyzed. Habitual snoring (HS) was reported in 104 (5.3%) children. DIMS and EDS were seen in 137 children (6.9%) and 117 children (5.9%), respectively. The prevalence of DIMS increased from 3.5% in children who never snored to 28.6% in children who snored very often or always. Similarly, the prevalence of EDS was 2.7% in children who did not snore and increased to 19% in children who snored very often or always. No correlation was seen between increasing DIMS (r = 0.006, p > 0.05) or EDS (r = -0.031, p > 0.05) scores and body mass index.



This study is the first to measure the symptoms of both DIMS and EDS in a general pediatric population and to assess the relationship between both DIMS and EDS and SDB in children. We found that children with more frequent snoring had a higher prevalence of DIMS as well as EDS; however, there was no correlation between body mass index and either DIMS or EDS symptom severity.
Department of Otorhinolaryngology, Faculty of Medicine and Dentistry, Medical University of Warsaw, Warsaw, Poland. Electronic address: wojciechkukwa@gmail.com.
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Kukwa
Department of Otorhinolaryngology, Faculty of Medicine and Dentistry, Medical University of Warsaw, Warsaw, Poland.
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Migacz
Department of Otolaryngology-Head Neck Surgery, University of Cincinnati, Cincinnati, Ohio, USA; Divisions of Pediatric Otolaryngology & Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
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Ishman
Third Department of Psychiatry and Sleep Disorders Center, Institute of Psychiatry and Neurology, Warsaw, Poland.
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Wichniak
D015992:Body Mass Index; D002648:Child; D003430:Cross-Sectional Studies; D006970:Disorders of Excessive Somnolence / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000150:complications* / Q000453:epidemiology; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology / Q000209:etiology*; D012913:Snoring / Q000150:complications / Q000453:epidemiology; D011795:Surveys and Questionnaires
Children; Insomnia; Questionnaire; Sleep-disordered breathing; Sleepiness; Snoring