SLEEP AND BEHAVIOR IN SCHOOLCHILDREN

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Bullying and aggressive behavior are common problems among elementary schoolchildren and often have mental health consequences for both perpetrators and victims. The neurobiological basis for bullying has received little study, but psychological testing and imaging of brain activity implicate dysfunction within a large area at the front of the brain called the prefrontal cortex. Disinhibited, impulsive, hyperactive, and aggressive behavior with prefrontal cortical dysfunction have also been observed in children with sleep disorders, particularly sleep-disordered breathing (SDB) such as obstructive sleep apnea. Sleep-disordered breathing is both highly prevalent and frequently undiagnosed in children. In preliminary data collected from parents in general pediatric waiting rooms, the investigators found a strong association between bullying and SDB symptoms, such as snoring. In another study they showed that aggressive behavior improves in children treated for SDB. The investigators now propose to perform the first prospective research on SDB and bullying in schoolchildren. Specific aims are to assess whether bullying is associated with SDB symptoms in 400 2nd, 3rd, 4th, and 5th grade students in the Ypsilanti Public Schools; to administer gold-standard sleep and behavioral assessments, in 25 bullies and 25 matched non-bullies, and compare evidence for SDB in the two groups; and to determine 9-12 months later whether diagnosis of SDB in some of the 25 bullying children led to improved behavior when clinically-indicated SDB treatment had been pursued. Results could lead to a more definitive, multi-center clinical trial aimed at reduction of bullying in urban school settings through identification and treatment of highly prevalent but often unsuspected SDB.'