Secondhand tobacco smoke exposure and sleep disturbance in school-aged children in Appalachian Ohio.

Compared to borderline significance in GEE, the following relationships became significant: (1) between increasing ln serum cotinine levels and frequent night awakenings (PR = 1.28, 95% CI: 1.01–1.63, p = 0.04) in the age-adjusted model, (2) increasing ln serum cotinine levels and having ≥1 sleep disturbance (PR = 1.11, 95% CI: 1.00–1.24, p = 0.048) in the fully adjusted model, and serum cotinine levels ≥0.05 ng/ml and having ≥1 sleep disturbance (PR = 1.46, 95% CI: 1.00–2.12, p = 0.049) in the age-adjusted model.

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Frequent night awakenings [PR = 2.64, (95% CI: 0.97, 7.20), p = .06] and having ≥1 sleep disturbance [PR = 1.39, (95% CI:0.98, 1.95), p = .06] reached near significance in age-adjusted models and further attenuated in fully adjusted models ( Table 2 ).

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Having ≥1 sleep disturbance [PR = 1.11 (95% CI: 0.99, 1.23), p = .07] approached significance but was not significant in the fully adjusted models.

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