{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T13:21:47Z","timestamp":1785763307899,"version":"3.56.0"},"reference-count":43,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2020,11,16]],"date-time":"2020-11-16T00:00:00Z","timestamp":1605484800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: Sleep-related breathing disorders (SRDB) are a group of pathological conditions characterized by a dysfunction of the upper airways. The value of SRDB\u2019s prevalence, in the pediatric population, ranges from 2 to 11% depending on the different methodologies used in measure and the difficulties in the diagnosis. The aim of this study was to assess the prevalence of SRDB using the Pediatric Sleep Questionnaire (PSQ). Methods: 668 patients were enrolled from the Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, Italy and from the Unit of Integrated Pediatric Dentistry, University of Murcia, Spain. The questionnaires were administered to patients with no previous orthodontic and surgical treatment who attended on the first visit at the two units of pediatric dentistry. Data regarding general health status were extracted from the standard anamnestic module for first visit. Prevalence and logistic regression models were computed. Results: The ages ranged from 2 to 16 years old (average 7 years old). The prevalence of SRDB was 9.7% for the entire sample. The models showed a positive correlation between three variables (snoring, bad habits, and anxiety) and SRDB. Conclusions: The prevalence obtained demonstrates the relevance of sleep disorders in the pediatric population and highlights the central role of pediatric dentists in the earlier diagnosis of these disorders.<\/jats:p>","DOI":"10.3390\/ijerph17228460","type":"journal-article","created":{"date-parts":[[2020,11,16]],"date-time":"2020-11-16T21:48:52Z","timestamp":1605563332000},"page":"8460","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Prevalence of Sleep-Disordered Breathing in Children Referring for First Dental Examination. A Multicenter Cross-Sectional Study Using Pediatric Sleep Questionnaire"],"prefix":"10.3390","volume":"17","author":[{"given":"Gabriele","family":"Di Carlo","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Rome, Italy"},{"name":"Department of Dentistry, Section of Orthodontics, Faculty of Health, Aarhus University, 8000 Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6561-3487","authenticated-orcid":false,"given":"Francesca","family":"Zara","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milena","family":"Rocchetti","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelica","family":"Venturini","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9113-8416","authenticated-orcid":false,"given":"Antonio Jos\u00e9","family":"Ortiz-Ruiz","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Stomatology, Radiology and Physical Medicine, University of Murcia, 30008 Murcia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Luzzi","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo Maria","family":"Cattaneo","sequence":"additional","affiliation":[{"name":"Department of Dentistry, Section of Orthodontics, Faculty of Health, Aarhus University, 8000 Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2679-7607","authenticated-orcid":false,"given":"Antonella","family":"Polimeni","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8545-9889","authenticated-orcid":false,"given":"Iole","family":"Vozza","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,11,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1387","DOI":"10.1378\/chest.14-0970","article-title":"International classification of sleep disorders-third edition: Highlights and modifications","volume":"146","author":"Sateia","year":"2014","journal-title":"Chest"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1183\/13993003.00385-2015","article-title":"Obstructive sleep disordered breathing in 2-to18-year-old children: Diagnosis and management","volume":"47","author":"Kaditis","year":"2016","journal-title":"Eur. Respir. J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e714","DOI":"10.1542\/peds.2012-1672","article-title":"Diagnosis and management of childhood obstructive sleep apnea syndrome","volume":"130","author":"Marcus","year":"2012","journal-title":"Pediatrics"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1136\/adc.68.3.360","article-title":"Snoring, sleep disturbance, and behaviour in4-5 year olds","volume":"68","author":"Ali","year":"1993","journal-title":"Arch. Dis. Child."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"American Thoracic Society (1996). Standards and indications for cardiopulmonary sleep studiesin children. Am. J. Respir. Crit. Care Med., 153, 866\u2013887.","DOI":"10.1164\/ajrccm.153.2.8564147"},{"key":"ref_6","first-page":"5","article-title":"Respiratory sleep disorders in children and role of the paediatric dentist","volume":"20","author":"Paglia","year":"2019","journal-title":"Eur. J. Paediatr. Dent."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1136\/thx.2010.143958","article-title":"Health, social and economical consequences of sleep-disorderedbreathing: A controlled national study","volume":"66","author":"Jennum","year":"2011","journal-title":"Thorax"},{"key":"ref_8","first-page":"311","article-title":"Sleep disordered breathing in children","volume":"131","author":"Guilleminault","year":"2010","journal-title":"Indian J. Med. Res."},{"key":"ref_9","first-page":"403","article-title":"Sleep disordered breathing and nocturnal polyuria: Nocturia andenuresis","volume":"7","author":"Umlauf","year":"2003","journal-title":"Med. Rev."},{"key":"ref_10","first-page":"w14400","article-title":"Obstructive sleep-disorderedbreathing, enuresis and combined disorders in children: Chance or related association?","volume":"3","author":"Zaffanello","year":"2017","journal-title":"Swiss Med. Wkly."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1097\/MOP.0b013e3283229b12","article-title":"Diagnosis and management of nocturnal enuresis","volume":"21","year":"2009","journal-title":"Curr. Opin. Pediatr."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1111\/j.1651-2227.1994.tb13136.x","article-title":"Nocturnal enuresis: Sleep disturbance and behavioural patterns","volume":"83","author":"Wille","year":"1994","journal-title":"Acta Paediatr."},{"key":"ref_13","first-page":"201039","article-title":"Influence of Orthodontic Rapid Maxillary Expansion on Nocturnal Enuresis in Children","volume":"2015","author":"Truszel","year":"2015","journal-title":"BioMed. Res. Int."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1016\/j.ijporl.2019.02.008","article-title":"Sleep disordered breathing in children-Diagnostic questionnaires, comparativeanalysis","volume":"120","author":"Burghard","year":"2019","journal-title":"Int. J. Pediatr. Otorhinolaryngol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1260","DOI":"10.1002\/alr.22219","article-title":"Allergic rhinitis and the associated risk of nocturnal enuresis in children: A population-based cohort study","volume":"8","author":"Lai","year":"2018","journal-title":"Int. Forum Allergy Rhinol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1429","DOI":"10.1056\/NEJMcp0808009","article-title":"Evaluation and management of enuresis","volume":"2","author":"Robson","year":"2009","journal-title":"N. Engl. J. Med."},{"key":"ref_17","unstructured":"Milano, F., Gracco, A.L., and Di Giosia, M. (2019). La Gestione Odontoiatrica Del Paziente Con Sindrome Delle Apnee Ostruttive Del Sonno, Edra."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"119","DOI":"10.2174\/138920209787846998","article-title":"Obstructive sleep apnea syndrome: From phenotype to genetic basis","volume":"10","author":"Casale","year":"2009","journal-title":"Curr. Genom."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1513\/pats.200708-135MG","article-title":"Epidemiology of pediatric obstructive sleep apnea","volume":"5","author":"Lumeng","year":"2008","journal-title":"Proc. Am. Thorac. Soc."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1542\/peds.102.3.616","article-title":"Sleep-disordered breathing and school performance in children","volume":"102","author":"Gozal","year":"1998","journal-title":"Pediatrics"},{"key":"ref_21","first-page":"19","article-title":"The orthodontist and the obstructive sleep apnea patient","volume":"23","author":"Pliska","year":"2012","journal-title":"Int. J. Orthod. Milwaukee"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1016\/j.ajodo.2019.05.015","article-title":"Pediatric sleep-disordered breathing in the orthodontic population: Prevalence of positive risk and associations","volume":"157","author":"Abtahi","year":"2020","journal-title":"Am. J. Orthod. Dentofacial. Orthop."},{"key":"ref_23","unstructured":"Daniel, E.J., Halle, R.A., Feltner, C., Palmieri, R.W., Arvanitis, M., Stine, A., Lux, L., Middleton, J.C., Voisin, C., and Harris, R.P. (2017). Screening for Obstructive Sleep Apnea in Adults: An Evidence Review for the U.S. PreventiveServices Task ForceEvidence Syntheses, No. 14, Agency for Healthcare Research and Quality (US)."},{"key":"ref_24","first-page":"517","article-title":"Risk ofbehavioral and adaptive functioning difficulties in youth with previous and current sleepdisordered breathing","volume":"36","author":"Perfect","year":"2013","journal-title":"Sleep"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1001\/archotol.126.4.494","article-title":"Impact of tonsillectomy and adenoidectomy on child behavior","volume":"126","author":"Goldstein","year":"2000","journal-title":"Arch. Otolaryngol. Head Neck Surg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/S1389-9457(99)00009-X","article-title":"Pediatric sleep questionnaire (PSQ): Validity and reliability of scales for sleep-disordered breathing, snoring, sleepiness, and behavioral problems","volume":"1","author":"Chervin","year":"2000","journal-title":"Sleep Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"576","DOI":"10.19256\/d.cadmos.09.2016.06","article-title":"Validazione linguistica di un questionario per la diagnosi dei disturbi respiratori del sonno nei bambini","volume":"84","author":"Ranieri","year":"2016","journal-title":"Dental. Cadmos."},{"key":"ref_28","first-page":"121","article-title":"Spanish version of the Pediatric Sleep Questionnaire (PSQ). A useful instrument in investigation of sleep disturbances in childhood. Reliability analysis","volume":"66","year":"2007","journal-title":"An. Pediatr."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"165","DOI":"10.14219\/jada.2013.26","article-title":"Diagnostic capability of questionnaires and clinical examinations to assess sleep-disordered breathing in children:a systematic review and meta-analysis","volume":"145","author":"Singh","year":"2014","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Lemeshow, S. (2013). Applied Logistic Regression, Wiley.","DOI":"10.1002\/9781118445112.stat06902"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1016\/j.patrec.2005.10.010","article-title":"An Introduction to ROC Analysis (PDF)","volume":"27","author":"Fawcett","year":"2006","journal-title":"Pattern Recognit. Lett."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Gulotta, G., Iannella, G., Vicini, C., Polimeni, A., Greco, A., De Vincentis, M., Visconti, I.C., Meccariello, G., Cammaroto, G., and De Vito, A. (2019). Risk Factors for Obstructive Sleep Apnea Syndrome in Children: State of the Art. Int. J. Environ. Res Public Health., 4.","DOI":"10.3390\/ijerph16183235"},{"key":"ref_33","first-page":"902","article-title":"The prevalence of snoring and its related family factors of children from 3 to 14 years old in Beijing","volume":"54","author":"Zhang","year":"2019","journal-title":"Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Tsukada, E., Kitamura, S., Enomoto, M., Moriwaki, A., Kamio, Y., Asada, T., Arai, T., and Mishima, K. (2018). Prevalence of childhood obstructive sleep apnea syndrome and its role in daytime sleepiness. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0204409"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1097\/MCP.0b013e32835b11a1","article-title":"Sleep-disordered breathing and childhood asthma: Clinical implications","volume":"19","author":"Ross","year":"2013","journal-title":"Curr. Opin. Pulm. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"369","DOI":"10.2147\/NDT.S35974","article-title":"Depressive symptoms and childhood sleep apnea syndrome","volume":"8","author":"Carotenuto","year":"2012","journal-title":"Neuropsychiatr. Dis. Treat."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.5664\/jcsm.3178","article-title":"The relationship between depressive symptoms and obstructive sleep apnea in pediatric populations: A meta-analysis","volume":"15","author":"Yilmaz","year":"2013","journal-title":"J. Clin. Sleep Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1016\/j.jaac.2013.06.001","article-title":"Assessment and management of sleep problems in youths with attention-deficit\/hyperactivity disorder","volume":"52","author":"Cortese","year":"2013","journal-title":"J. Am. Acad. Child Adolesc. Psychiatry"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1640","DOI":"10.1542\/peds.2004-0103","article-title":"Increased behavioral morbidity in school-aged children with sleep-disordered breathing","volume":"114","author":"Rosen","year":"2004","journal-title":"Pediatrics"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"zsy180","DOI":"10.1093\/sleep\/zsy180","article-title":"Depressive symptomatology in school-aged children with obstructive sleep apnea syndrome: Incidence, demographic factors, and changes following a randomized controlled trial of adenotonsillectomy","volume":"41","author":"Hodges","year":"2018","journal-title":"Sleep"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1016\/j.otohns.2007.11.003","article-title":"Pediatric obstructive sleep apnea and quality of life: A meta-analysis","volume":"138","author":"Baldassari","year":"2008","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"6530539","DOI":"10.1155\/2019\/6530539","article-title":"Emotional Intelligence in Children with Severe Sleep-Related Breathing Disorders","volume":"2019","author":"Operto","year":"2019","journal-title":"Behav. Neurol."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Sfasciotti, G.L., Zara, F., Fioravanti, M., Guaragna, M., Palaia, G., and Polimeni, A. (2020). Frenulectomy with Diode Laser Technology in Pediatric Patients: Quantitative and Qualitative Evaluations. Randomized Double-Blind Clinical Trial. Appl. Sci., 10.","DOI":"10.3390\/app10124114"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/22\/8460\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:33:48Z","timestamp":1760178828000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/22\/8460"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,16]]},"references-count":43,"journal-issue":{"issue":"22","published-online":{"date-parts":[[2020,11]]}},"alternative-id":["ijerph17228460"],"URL":"https:\/\/doi.org\/10.3390\/ijerph17228460","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11,16]]}}}