Habitual snoring in primary school children: prevalence and association with sleep-related disorders and school performance

ABSTRACT

To determine the prevalence of habitual snoring [HS] and its association with both day- and nighttime symptoms, school performance and behavioral disturbances in a sample of primary school children. A cross-sectional study was performed on 1,605 children [819 boys and 786 girls] aged 7-13 years from 9 randomly selected primary schools located within the city limits of Isparta, Turkey. HS and sleep problems were assessed using a 55-item multiple-choice questionnaire. Of the 1,605 questionnaires, 1,164 were fully completed and returned, giving a response rate of 72.5%. The overall prevalence of snoring was 38.9%, while HS accounted for 3.5%. The prevalence of HS among boys [25,3.0%] was higher than among girls [16, 2.0%; chi[2] for trend p < 0.001, OR 1.92, 95% Cl 1.01-3.66]. There was an association between younger age and HS, as children aged 7-8 years had the highest prevalence [chi[2] for trend 0.054, OR 1.85, 95% Cl 0.81-4.22]. Habitual snorers had more daytime and nighttime symptoms. Allergic symptoms, daytime mouth breathing, shaking the child for apnea, restless sleep and hyperactivity were significant and independent risk factors and sleep-related symptoms for HS. A significant and independent association was found between poor school performance and hyperactivity, nocturnal enuresis, tooth grinding and low parental/ maternal education in multivariate analysis. Children with HS were more likely to have sleep-related daytime and nighttime symptoms. No significant association was determined between HS and poor school performance