Parent versus teacher report of daytime behavior in snoring children

Problematic behavior is widely reported in children with sleep-disordered breathing (SDB). Daytime behavior is an important component in the evaluation of clinical history in SDB; however, there is a reliance on parental report alone, and it is unclear whether reports by teachers will aid diagnosis. We assessed sleep and behavior reported by both parents and teachers in 19 children with SDB and 27 non-snoring controls. All children were screened for prior diagnoses of other medical and/or behavior and learning disorders and underwent polysomnography and both parental and teacher assessment of behavior. Both parents and teachers report greater problematic behavior in SDB children, predominantly of an internalizing nature. Despite this consistency and moderate correlation between informants, the agreement between parent and teacher reports of individual child behavior was poor when assessed using Bland-Altman plots. Clinicians should be mindful that the behavioral history of a child being evaluated for SDB may vary depending on whether parent or teacher report is being discussed as this may influence clinical decision making.