Pediatric Daytime Sleepiness Scale (PDSS), we found that somnolence was independently and signifi cantly related to poor grades in language or math after adjusting for age, gender, body mass index (BMI), and the presence of snoring or apneas.2 Daytime somnolence in sleep deprived children may lead to reduced attention, causing impaired learning and academic failure.10 background: A multi-step causality pathway connecting short sleep duration to daytime somnolence and sleepiness leading to reduced attention and poor academic performance as the fi nal result can be envisaged. However this hypothesis has never been explored. Objective: To explore consecutive correlations between sleep duration, daytime somnolence, attention levels, and academic performance in a sample of school-aged teenagers. Methods: We carried out a survey assessing sleep duration and daytime somnolence using the Pediatric Daytime Sleepiness Scale (PDSS). Sleep duration variables included weekdays' total sleep time, usual bedtimes, and absolute weekdayto-weekend sleep time difference. Attention was assessed by d2 test and by the coding subtest from the WISC-IV scale. Academic performance was obtained from literature and math grades. Structural equation modeling was used to assess the independent relationships between these variables, while controlling for confounding effects of other variables, in one single model. Standardized regression weights (SWR) for relationships between these variables are reported. Results: Study sample included 1,194 teenagers (mean age: 15 years; range: 13-17 y). Sleep duration was inversely associated with daytime somnolence (SWR = -0.36, p < 0.01) while sleepiness was negatively associated with attention (SWR = -0.13, p < 0.01). Attention scores correlated positively with academic results (SWR = 0.18, p < 0.01). Daytime somnolence correlated negatively with academic achievements (SWR = -0.16, p < 0.01). The model offered an acceptable fi t according to usual measures (RMSEA = 0.0548, CFI = 0.874, NFI = 0.838). A Sobel test confi rmed that short sleep duration infl uenced attention through daytime somnolence (p < 0.02), which in turn infl uenced academic achievements through reduced attention (p < 0.002). Conclusions: Poor academic achievements correlated with reduced attention, which in turn was related to daytime somnolence. Somnolence correlated with short sleep duration. keywords: Sleep deprivation, daytime somnolence, attention, academic performance, structural equation modeling Citation: Perez-Lloret S; Videla AJ; Richaudeau A; Vigo D; Rossi M; Cardinali DP; Perez-Chada D. A multi-step pathway connecting short sleep duration to daytime somnolence, reduced attention, and poor academic performance: an exploratory cross-sectional study in teenagers. J Clin Sleep Med 2013;9(5):469-473.http://dx.doi.org/10.5664/jcsm.2668 S C I E N T I F I C I N V E S T I g A T I O N SI nsuffi cient sleep time in school-aged teenagers is a common phenomenon. A recent meta-analysis of 41 studies on adolescent sleep patterns surveys sh...

We studied behavior in a group of children with specific language impairment in its 2 subtypes (expressive and mixed receptive/expressive). After exclusion of other psychiatric conditions, we evaluated 114 children of ages 2 to 7 years using language developmental tests and behavioral screening scales. Behavior problems appeared in 54% of the children. Withdrawn was the most frequently found syndrome in preschool children, whereas anxious/depressed and social problems were the most frequent in older children. The high frequency of behavioral syndromes in children with specific language impairment is remarkable and requires the awareness of primary attendants and specialists. Anxiety, depression, social isolation, and aggressive and rule-breaking behavior can obscure identification of the language impairment. Taking into account this relationship would improve the chances of a timely and appropriate intervention.

The SNAP-IV scale for detection of ADHD is considered to be valid in the population studied as long as the cut-off scores are modified to obtain the best sensitivity/specificity ratio based on the cultural and socioeconomic features of the population.

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