STUDY OBJECTIVES: To examine the prevalence and distribution of the symptoms of sleep-disordered breathing (SDB) in a community-based sample of adolescents, and to assess association of SDB with body mass index, daytime sleepiness, school performance, and attention-deficit/hyperactivity disorder. DESIGN: Epidemiologic study of a community-based sample of adolescents and 1 parent with whom separate structured face to face diagnostic interviews were conducted. SETTING: Metropolitan Detroit, Michigan, USA. PARTICIPANTS: One thousand fourteen adolescents aged 13 to 16 years and a paired parent. MEASURES AND RESULTS: SDB was defined as report of loud snoring, gasping/choking or snorting, awakening with gasping or choking, or momentary periods of stopped or abnormal breathing occurring weekly. More than 20% of the adolescents snored at least a few nights per month, 6% snoring every or nearly every night. Apnea-like symptoms affected from 2.5% to 6.1% of adolescents. The prevalence of weekly SDB was 6.0% according to both adolescent and parental report and was twice as likely among African Americans as Caucasians. The association of body mass index with SDB was twice as great among Caucasian adolescents as African American adolescents. SDB was independently associated with excessive daytime sleepiness, poorer grade point averages, and attention-deficit/hyperactivity disorder-inattention type; each being more than twice as likely to occur among those with SDB than those without SDB. CONCLUSIONS: Symptoms of SDB appear to be common among adolescents and independently associated with short- and longer-term adverse outcomes. These associations appear to be complex in the population and will require longitudinal epidemiologic studies to clarify the nature of their relationships and the opportunities for intervention
