Behavioral and emotional characteristics of Canadian children with obesity and moderate-severe sleep-disordered breathing treated with positive airway pressure: longitudinal changes and associations with adherence

Autor: Evelyn, Constantin, Joanna E, MacLean, Nicholas, Barrowman, Linda, Horwood, Glenda N, Bendiak, Valerie G, Kirk, Stasia, Hadjiyannakis, Laurent, Legault, Bethany J, Foster, Sherri L, Katz
Rok vydání: 2023
Předmět:
Zdroj: Journal of Clinical Sleep Medicine. 19:555-562
ISSN: 1550-9397
1550-9389
Popis: Behavioral characteristics and outcomes of positive airway pressure (PAP) therapy in children with obesity and moderate-severe sleep-disordered breathing (SDB) have not been reported. Our aims were to 1) determine baseline behavioral/emotional symptoms of this population and characterize changes over time with PAP; and 2) examine associations between baseline behavioral/emotional symptoms and PAP adherence.This multicenter prospective cohort study of children with obesity prescribed PAP for moderate-severe SDB assessed PAP adherence (≥4h/night,50% of nights; usage diaries, downloads) and compared behavioral/emotional characteristics with parent/child-reported Conners Rating Scale (Conners) and the Child Behavior Checklist (CBCL) at baseline and 1 year after PAP prescription between adherent/non-adherent participants; scores at baseline were compared retrospectively between adherence groups.Twenty-four children were included (median 14.1 years (IQR:12.4,16.0); 87.5% males). Baseline Conners and CBCL scores were elevated (parent- and child-reported Conners inattention and hyperactivity subscales and CBCL subscales - total, internalizing, externalizing). Baseline parent-reported Conners scores were significantly more elevated in the non-adherent than adherent group (inattention: 73.3±8.5 vs. 60.5±14.6, p=0.01; hyperactivity: 70.9±11.1 vs. 59.1±16.0, p=0.05). This difference was present 1 year later for inattention (p=0.01) but not for hyperactivity (p=0.09). Parent-reported CBCL scores improved over one year in adherent but not non-adherent participants.We found that children with obesity and moderate-severe SDB have elevated symptoms of behavioral/emotional concerns on standardized testing. Parent-reported emotional characteristics improved in the adherent but not in the non-adherent group. Children with greater inattention/hyperactivity at baseline were less adherent to PAP, suggesting this may contribute to PAP non-adherence.
Databáze: OpenAIRE
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