Ann Med. 2025 Dec;57(1):2460771. doi: 10.1080/07853890.2025.2460771. Epub 2025 Sep 14.
ABSTRACT
BACKGROUND: The association between allergic rhinitis (AR) and behaviour problems (BPs) is still controversy. Furthermore, potential critical mediating role of sleep disturbance (SD) in their association has not been explored.
METHODS: A total of 18,316 children aged 6 to 12 (mean age 7.89 years, male: 53.1%) were recruited from 34 primary schools from Shanghai, China. Demographic information, medical history, Children’s Sleep Habits Questionnaire (CSHQ), and Conners’ Parent Rating Scale (CPRS) were reported or scored by guardians via online survey. Logistic regression models with adjustment were employed to investigate the association between self-reported AR and BPs. Reproducible mediation analyses were used to explore the mediation effect of SD.
RESULTS: The prevalence of AR, SD and any BP was 32.9%, 23.3% and 18.0%, respectively. Adjusted odds ratios (ORs) for BPs were significantly higher in children with AR compared to those without (all p < 0.001): for conduct problems the OR was 1.77 (95% CI 1.54-2.03); learning problems 1.67 (1.48-1.89); psychosomatic problems 1.82 (1.56-2.12); impulsive-hyperactive 1.68 (1.50-1.88); anxiety 1.36 (1.19-1.55); and hyperactivity 1.67 (1.49-1.88). Mediation analysis indicated that SD mediated the association between AR and BPs, with mediation proportions ranging from 32.6% to 64.1% (all p < 0.001), among which daytime sleepiness and sleep disordered breathing contributed most.
CONCLUSIONS AND RELEVANCE: Children with AR have higher odds of presenting BPs, and SD significantly mediates these associations. These results highlight the importance of proper screening and management of SD and BPs in urban children with AR.
TRIAL REGISTRATION: registration name (Effect of OSAHS on cognitive behavioural dysfunction in school-aged children: a large-scale prospective cohort study); registration number (ChiCTR1800014488); URL of the registry (https://www.chictr.org.cn/showproj.html?proj=24763).
PMID:40946322 | DOI:10.1080/07853890.2025.2460771
