Correlation between Obstructive Sleep Apnea Syndrome and Emotional-behavioural Problems in Preschool Children

doi:10.12114/j.issn.1007-9572.2025.0232

Chinese General Practice ›› 2026, Vol. 29 ›› Issue (09): 1155-1160.DOI: 10.12114/j.issn.1007-9572.2025.0232

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Correlation between Obstructive Sleep Apnea Syndrome and Emotional-behavioural Problems in Preschool Children

1. Respiratory Department, Beijing Children's Hospital, Capital Medical University/National Center for Children's Health, Beijing 100045, China
2. Department of Pediatrics, Xuanwu Hospital Capital Medical University, Beijing 100053, China
3. Department of Pediatric ENT, Head & Neck Surgery, Beijing Children's Hospital, Capital Medical University/National Center for Children's Health, Beijing 100045, China
4. National Center for Children's Health/National Clinical Research Center of Respiratory Disease, Beijing 100045, China

Received:2025-07-23 Revised:2025-09-15 Published:2026-03-20 Online:2026-01-28
Contact: XU Zhifei

阻塞性睡眠呼吸暂停综合征与学龄前儿童情绪行为问题的相关性研究

1．100045　北京市，国家儿童医学中心　首都医科大学附属北京儿童医院呼吸科
2．100053　北京市，首都医科大学宣武医院儿科
3．100045　北京市，国家儿童医学中心　首都医科大学附属北京儿童医院耳鼻咽喉头颈外科
4．100045　北京市，国家儿童医学中心　国家呼吸系统疾病临床医学研究中心

通讯作者: 许志飞
作者简介:
作者贡献：
许志飞负责研究设计工作；吴云肖承担研究实施、质量控制和资料收集的任务；管艳萍负责研究的实施和数据收集、整理工作，并负责撰写论文；许志飞负责本文的审阅与校对工作。
基金资助:
国家自然科学基金资助项目(82070092); 北京市科委中关村管委会概念验证平台建设项目——儿童创新医疗器械概念验证平台(2024030119)

Abstract

Abstract:

Background

Obstructive sleep apnea syndrome (OSAS) may affect children's cognitive functions, including learning abilities, memory, executive function, and attention.

Objective

To investigat the correlation between OSAS and emotional-behavioral problems in preschool children through the Conners Children Behavioral Questionnaire for parents (Conners' Rating Scale).

Methods

Data were collected from October 2022 to October 2023, 672 cases of children aged 3 to 7 years old who visited the Sleep Center of Beijing Children's Hospital, Capital Medical University for nighttime sleep accompanied by snoring were selected as research subjects. The participating children all completed a full-night polysomnography (PSG) monitoring and Conners' Rating Scale. 477 cases of OSAS children were selected according to the obstructive sleep apnea hypoventilation index (OAHI), including 297 boys and 180 girls; 27 cases aged 3, 164 cases aged 4, 173 cases aged 5, and 113 cases aged 6. Conners' Rating Scale was used to analyze the scores of conduct behavior, learning issues, psychosomatic disorders, impulsivity-hyperactivity, anxiety, and hyperactivity index in OSAS children of different genders and ages. Use Spearman's rank correlation coefficient to analyze the correlation between OSAS-related indicators [sleep efficiency, proportion of non-rapid eye movement sleep stage 1 (N1%), stage 2 (N2%), stage 3 (N3%), and the proportion of rapid eye movement sleep (REM%) to total sleep time, OAHI, oxygen desaturation index (ODI), average blood oxygen saturation (SpO₂), and minimum SpO₂] and the Conners' Rating Scale factor correlations, and multiple linear regression analyses were used to explore the effects of OSAS-related indicators on emotional-behavioral issues in preschool children.

Results

Compared with the Chinese norms, this study found that OSAS boys scored lower on the Conners' Rating Scale for learning problems, while scoring higher on psychosomatic issues, impulsivity-hyperactivity, and hyperactivity index (P<0.05); the OSAS girls in this study scored higher on psychosomatic issues and impulsivity-hyperactivity on the Conners' Rating Scale (P<0.05). Boys scored higher than girls on the Conners' Rating Scale for conduct problems, impulsivity-hyperactivity, and hyperactivity index (P<0.05). There was a statistically significant difference (P<0.05) in the scores for learning problems and psychosomatic disorders on the Conners' Rating Scale among children with OSAS of different ages. The results of the Spearman rank correlation analysis showed that N2% was positively correlated with Conners' Rating Scale learning problem score (P<0.05); N3% and REM% were negatively correlated with Conners' Rating Scale for conduct problems, learning problems, psychosomatic disorders, impulsivity-hyperactivity, anxiety, and hyperactivity index (P<0.05). The results of the multiple linear regression analysis showed that N2% can increase the factor score for learning problems on the Conners' Rating Scale, while N3% can decrease the factor score for conduct behavior, impulsivity-hyperactivity, and anxiety on the Conners' Rating Scale, REM% can lower the factor scores for learning problems and anxiety on the Conners' Rating Scale (P<0.05).

Conclusion

Our research results indicate that compared to the Chinese norm, both boys and girls with preschool OSAS have psychosomatic disorders and impulsive-hyperactivity issues, and boys exhibit more problems than girls concerning conduct behaviors, impulsivity-hyperactivity, and hyperactivity indices. N3% and REM% show a negative correlation with emotional and behavioral issues in preschool children, which may influence certain emotional and behavioral issues to varying degrees.

Key words: Obstructive sleep apnea syndrome, Cognitive function, Child, preschool, Conners Children Behavioral Questionnaire

摘要：

背景

阻塞性睡眠呼吸暂停综合征（OSAS）可能影响儿童的认知功能，包括学习能力、记忆力、执行功能和注意力等方面。

目的

旨在通过Conners儿童行为问卷（父母版）（简称Conners量表）研究OSAS与学龄前儿童情绪行为问题的相关性。

方法

于2022年10月—2023年10月，选取首都医科大学附属北京儿童医院睡眠中心因夜间睡眠伴有打鼾而就诊的672例3~7岁儿童作为研究对象。受试儿童均完成整夜的多导睡眠图监测（PSG）及Conners量表评估。根据阻塞性睡眠呼吸暂停低通气指数（OAHI）筛选出OSAS儿童477例，其中，男童297例，女童180例；3岁27例，4岁164例，5岁173例，6岁113例。采用Conners量表评估不同性别、不同年龄OSAS儿童品行行为、学习问题、心身障碍、冲动-多动、焦虑、多动指数得分。运用Spearman秩相关分析探讨OSAS相关指标[睡眠效率、非快速眼动睡眠1期占比（N1%）、2期占比（N2%）、3期占比（N3%）及快速眼动睡眠占总睡眠时间的比例（REM%）、OAHI、氧减指数（ODI）、平均血氧饱和度（SpO₂）、最低SpO₂]与Conners量表因子相关性，采用多元线性回归分析探讨OSAS相关指标对学龄前儿童情绪行为问题的影响。

结果

与中国常模相比，本研究OSAS男童Conners量表学习问题得分较低，心身障碍、冲动-多动、多动指数得分较高（P<0.05）；本研究OSAS女童Conners量表心身障碍、冲动-多动得分较高（P<0.05）。男童Conners量表品行行为、冲动-多动、多动指数得分高于女童（P<0.05）。不同年龄OSAS儿童Conners量表学习问题、心身障碍得分比较，差异有统计学意义（P<0.05）。Spearman秩相关分析结果显示，N2%与Conners量表学习问题得分呈正相关（P<0.05）；N3%、REM%与Conners量表品行行为、学习问题、心身障碍、冲动-多动、焦虑、多动指数得分均呈负相关（P<0.05）。多元线性回归分析结果显示，N2%可增加Conners量表学习问题因子得分，N3%可降低Conners量表品行行为、冲动-多动、焦虑因子得分，REM%可降低Conners量表学习问题、焦虑因子得分（P<0.05）。

结论

中国常模相比，学龄前OSAS男女童均存在心身障碍、冲动-多动问题，男童较女童在品行行为、冲动-多动、多动指数方面存在更多问题。N3%、REM%与学龄前儿童情绪行为问题均呈负相关，其中N3%增加可降低品行行为、冲动-多动、焦虑问题，REM%增加可降低学习问题、焦虑问题。

关键词: 阻塞性睡眠呼吸暂停综合征, 认知功能, 儿童，学龄前, Conners儿童行为问卷

CLC Number:

R 563.8

GUAN Yanping,WU Yunxiao,XU Zhifei. Correlation between Obstructive Sleep Apnea Syndrome and Emotional-behavioural Problems in Preschool Children[J]. Chinese General Practice, 2026, 29(09): 1155-1160. DOI: 10.12114/j.issn.1007-9572.2025.0232.
管艳萍,吴云肖,许志飞. 阻塞性睡眠呼吸暂停综合征与学龄前儿童情绪行为问题的相关性研究[J]. 中国全科医学, 2026, 29(09): 1155-1160. DOI: 10.12114/j.issn.1007-9572.2025.0232.

Figures/Tables 4

References 22

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项目	男童				女童				男童/女童
项目	本研究（n=297）	中国常模（n=194）	t值	P值	本研究（n=180）	中国常模（n=157）	t值	P值	男童（n=297）	女童（n=180）	t值	P值
品行行为	0.47±0.33	0.48±0.36	-0.317	0.752	0.39±0.33	0.39±0.27	<0.001	>0.999	0.47±0.33	0.39±0.33	2.532	0.012
学习问题	0.43±0.19	0.64±0.53	-5.301	<0.001	0.45±0.19	0.49±0.42	-1.099	0.273	0.43±0.19	0.45±0.19	-1.115	0.266
心身障碍	0.22±0.32	0.15±0.24	2.763	0.006	0.25±0.36	0.11±0.20	4.484	<0.001	0.22±0.32	0.25±0.36	-0.969	0.333
冲动-多动	0.70±0.53	0.58±0.56	2.398	0.017	0.59±0.55	0.47±0.44	2.223	0.027	0.70±0.53	0.59±0.55	2.215	0.027
焦虑	0.46±0.48	0.43±0.37	0.779	0.436	0.40±0.43	0.40±0.35	<0.001	>0.999	0.46±0.48	0.40±0.43	1.373	0.170
多动指数	0.64±0.50	0.55±0.43	2.124	0.034	0.52±0.44	0.45±0.35	1.625	0.105	0.64±0.50	0.52±0.44	2.718	0.007

项目	男童				女童				男童/女童
项目	本研究（n=297）	中国常模（n=194）	t值	P值	本研究（n=180）	中国常模（n=157）	t值	P值	男童（n=297）	女童（n=180）	t值	P值
品行行为	0.47±0.33	0.48±0.36	-0.317	0.752	0.39±0.33	0.39±0.27	<0.001	>0.999	0.47±0.33	0.39±0.33	2.532	0.012
学习问题	0.43±0.19	0.64±0.53	-5.301	<0.001	0.45±0.19	0.49±0.42	-1.099	0.273	0.43±0.19	0.45±0.19	-1.115	0.266
心身障碍	0.22±0.32	0.15±0.24	2.763	0.006	0.25±0.36	0.11±0.20	4.484	<0.001	0.22±0.32	0.25±0.36	-0.969	0.333
冲动-多动	0.70±0.53	0.58±0.56	2.398	0.017	0.59±0.55	0.47±0.44	2.223	0.027	0.70±0.53	0.59±0.55	2.215	0.027
焦虑	0.46±0.48	0.43±0.37	0.779	0.436	0.40±0.43	0.40±0.35	<0.001	>0.999	0.46±0.48	0.40±0.43	1.373	0.170
多动指数	0.64±0.50	0.55±0.43	2.124	0.034	0.52±0.44	0.45±0.35	1.625	0.105	0.64±0.50	0.52±0.44	2.718	0.007

年龄	例数	品行行为	学习问题	心身障碍	冲动-多动	焦虑	多动指数
3岁	27	0.49±0.31	0.31±0.17	0.31±0.46	0.81±0.51	0.57±0.59	0.69±0.50
4岁	164	0.45±0.34	0.39±0.19	0.26±0.32	0.64±0.54	0.45±0.45	0.60±0.46
5岁	173	0.40±0.32	0.43±0.19	0.25±0.38	0.68±0.54	0.42±0.44	0.60±0.47
6岁	113	0.47±0.36	0.54±0.15	0.16±0.23	0.62±0.56	0.41±0.48	0.55±0.52
F值		1.692	19.360	2.923	1.063	0.903	0.745
P值		0.168	<0.001	0.034	0.365	0.440	0.526

年龄	例数	品行行为	学习问题	心身障碍	冲动-多动	焦虑	多动指数
3岁	27	0.49±0.31	0.31±0.17	0.31±0.46	0.81±0.51	0.57±0.59	0.69±0.50
4岁	164	0.45±0.34	0.39±0.19	0.26±0.32	0.64±0.54	0.45±0.45	0.60±0.46
5岁	173	0.40±0.32	0.43±0.19	0.25±0.38	0.68±0.54	0.42±0.44	0.60±0.47
6岁	113	0.47±0.36	0.54±0.15	0.16±0.23	0.62±0.56	0.41±0.48	0.55±0.52
F值		1.692	19.360	2.923	1.063	0.903	0.745
P值		0.168	<0.001	0.034	0.365	0.440	0.526

项目	N1%	N2%	N3%	REM%	OAHI	AHI	ODI	平均SpO₂	最低SpO₂
品行行为	0.072	-0.022	-0.725^a	-0.188^a	0.044	0.044	0.011	-0.041	-0.044
学习问题	-0.030	0.107^a	-0.167^a	-0.139^a	0.026	0.026	0.018	0.065	0.012
心身障碍	-0.002	0.048	-0.238^a	-0.091^a	-0.063	-0.069	-0.073	0.003	-0.015
冲动-多动	0.046	-0.043	-0.749^a	-0.230^a	-0.005	0.002	-0.031	0.052	0.026
焦虑	0.061	0.066	-0.232^a	-0.088^a	-0.002	-0.026	-0.068	0.043	0.026
多动指数	0.034	-0.037	-0.705^a	-0.217^a	-0.041	-0.047	-0.050	0.047	0.035

Correlation between Obstructive Sleep Apnea Syndrome and Emotional-behavioural Problems in Preschool Children

阻塞性睡眠呼吸暂停综合征与学龄前儿童情绪行为问题的相关性研究

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项目	品行行为		学习问题		心身障碍		冲动-多动		焦虑		多动指数
项目	β	P值	β	P值	β	P值	β	P值	β	P值	β	P值
N2%	-0.085	0.129	0.139	0.012	-0.079	0.161	-0.103	0.065	-0.078	0.162	-0.07	0.210
N3%	-0.123	0.034	0.094	0.095	-0.070	0.226	-0.130	0.024	-0.146	0.011	-0.079	0.171
REM%	-0.030	0.563	-0.159	0.001	-0.022	0.674	-0.029	0.570	-0.120	0.018	0.068	0.179

项目	品行行为		学习问题		心身障碍		冲动-多动		焦虑		多动指数
项目	β	P值	β	P值	β	P值	β	P值	β	P值	β	P值
N2%	-0.085	0.129	0.139	0.012	-0.079	0.161	-0.103	0.065	-0.078	0.162	-0.07	0.210
N3%	-0.123	0.034	0.094	0.095	-0.070	0.226	-0.130	0.024	-0.146	0.011	-0.079	0.171
REM%	-0.030	0.563	-0.159	0.001	-0.022	0.674	-0.029	0.570	-0.120	0.018	0.068	0.179