International article
Self-reported organic and nonorganic sleep problems in schoolchildren aged 11 to 15 years in vienna

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Abstract

Purpose

To estimate the prevalence of self-reported sleep problems, to examine associations among demographic characteristics, familial factors, and sleep problems, and to investigate the association between the symptoms of obstructive sleep apnea (OSA) and nonorganic sleep disorders.

Methods

An anonymous questionnaire with 22 questions was designed. 332 schoolchildren (aged 11–15 years, mean age 12 years and 9 months; median, 12 years; 56% female, 44% male) from two high schools in Vienna were investigated with regard to self-reported symptoms characteristic for obstructive sleep apnea and for parasomnia/insomnia. Data were analyzed by definition of three groups (problem, occasional problem, and nonproblem sleepers, and by calculation of an insomnia/parasomnia sum score). Statistical analysis included nonparametric tests (Mann Whitney-U and Kruskal), Pearson correlation test, and multiple regression analysis.

Results

Twelve percent reported at least one sleep problem every night, 76% reported occasional sleep problems, and 12% had no sleep problems. Girls were affected more frequently than boys (p < .01). Children with sleep problems suffered more often from concentration difficulties (p < .05), daytime fatigue (p < .001), and daytime naps (p < .05). Children who snored had nightmares (10% vs. 2%, p < .01), night terrors (4% vs. 1.5%, p < .001), sleepwalking (1.4% vs. 1%, p < .05), and nocturnal awakening (16% vs. 5%, p < .01) more frequently. On multiple regression analysis, 23% of the variability of a defined parasomnia/insomnia sum score had the characteristic OSA symptoms of nocturnal sweating, dryness of the mouth, snoring, hyperactivity, and daytime fatigue.

Conclusion

12% of schoolchildren aged 11–15 years reported sleep problems almost every night. The children suffer from daytime fatigue, naps, and concentration difficulties. Nearly one-fourth of the symptoms of parasomnia/insomnia were associated with characteristic signs of OSA, suggesting the importance of a routine clinical investigation in children with so-called nonorganic sleep disorders.

Section snippets

Subjects and setting

The study was performed in Vienna, Austria, a city with a population of 1.7 million, of which 80,000 are schoolchildren aged between 11 and 15 years [16]. Two high schools from two major districts (districts 3 and 23) of the city were selected for the study. On the basis of parental educational degree and families’ housing space, schools were classified as average municipal schools according to the Austrian Bureau of Statistics [16]. Based on the native language of the students, ethnic

Descriptive results

The response rate was nearly 100%; only 1 of 333 students had to be excluded because of parental concern. The mean age of the cohort was 12 years and 9 months (range, 10.5–15.9 years; median, 12 years) and the age distribution was as follows: 10.5–11.9 years, 18%; 12–12.9 years, 33%; 13–13.9 years, 30%; 14–14.9 years, 17%; 15–15.9 years, 2%. The sample consisted of 56% female and 44% male subjects. The frequency of self-reported sleep problems is shown in Table 1.

Based on responses to the

Discussion

We investigated the frequency of self-reported symptoms characteristic of obstructive sleep apnea and parasomnia/insomnia in schoolchildren aged 11 to 15 years.

Sleep disorders in children have been extensively discussed in recent times. The large number of publications on this subject in the last few years demonstrates the pediatrician’s efforts to fill the paucity of knowledge concerning sleep medicine. Behavioral and learning problems as well as poor performance at school are some of the

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    Copyright © 2002 Society for Adolescent Medicine. Published by Elsevier Inc. All rights reserved.