Loud Snoring in Young Children May Predict Behavior Issues

A new study claims that young children and preschoolers that snore may predict behavior issues in the future.

Persistent and loud snoring in young children is associated with problem behaviors, according to a new study published online in Pediatrics.

These behaviors include hyperactivity, depression and inattention, according to Dean Beebe, PhD, director of the neuropsychology program at Cincinnati Children's Hospital Medical Center and lead author of the study.

"The strongest predictors of persistent snoring were lower socioeconomic status and the absence or shorter duration of breastfeeding," says Dr. Beebe. "This would suggest that doctors routinely screen for and track snoring, especially in children from poorer families, and refer loudly-snoring children for follow-up care. Failing to screen, or taking a 'wait and see' approach on snoring, could make preschool behavior problems worse. The findings also support the encouragement and facilitation of infant breastfeeding."

The study is believed to be the first to examine the relationship between the persistence of snoring and behavior problems in preschool-age children. Persistent, loud snoring occurs in approximately one of every 10 children.

Dr. Beebe and colleagues at Cincinnati Children's studied 249 children. The researchers surveyed the children's moms about their kids' sleep and behaviors. The study showed that children who snored loudly at least twice a week at the age of 2 and 3 had more behavior problems than children who either don't snore or who snored at 2 or 3 but not at both ages.

"A lot of kids snore every so often, and cartoons make snoring look cute or funny. But loud snoring that lasts for months is not normal, and anything that puts young kids at that much risk for behavioral problems is neither cute nor funny," says Dr. Beebe. "That kind of snoring can be a sign of real breathing problems at night that are treatable. I encourage parents to talk to their child's doctor about loud snoring, especially if it happens a lot and persists over time."

Infant breastfeeding, especially over longer periods of time, seemed to protect children against persistent snoring, even after taking into account other factors, including family income.

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A window of opportunity for intervention? Early identification of sleep problems in preschool children with behavioral problems.

This is a very interesting article. It is well known that children develop cognitive problems when they have sleep apnea. IQ drops. Neuronal in the hippocampus  is lost.  However,  there may be a window to intervene early  before the evolution of cognitive problems.  


This article suggests that children with behavioral problems should be screened for sleep apnea early before cognitive problems are noted. JR

Sleep-disordered breathing in preschool children is associated with behavioral, but not  cognitive, impairments.

Jackman AR, Biggs SN, Walter LM, Embuldeniya US, Davey MJ, Nixon GM, Anderson V, Trinder J, Horne RS.

Source

Sleep Med. 2012 Jun;13(6):621-31. Epub 2012 Apr 13.Psychological Sciences, The University of Melbourne, Melbourne, Australia.

Abstract

BACKGROUND:

Sleep-disordered breathing (SDB) has been associated with impaired cognitive and behavioral function in school children; however, there have been limited studies in preschool children when the incidence of the disorder peaks. Thus, the aim of this study was to compare cognitive and behavioral functions of preschool children with SDB to those of non-snoring control children.

METHODS:

A clinical sample of 3-5year-old children (primary snoring [PS], n=60; mild obstructive sleep apnea syndrome [OSAS], n=32; moderate/severe [MS] OSAS, n=24) and a community sample of non-snoring control children (n=37) were studied with overnight polysomnography. Cognitive performance and behavioral information were collected.

RESULTS:

Children with PS and mild OSAS had poorer behavior than controls on numerous measures (p<.05-p<.001), and on some measures they had poorer behavior than the MS OSAS group (p<.05). In contrast, all groups performed similarly on cognitive assessment. Outcomes related more to sleep than respiratory measures.

CONCLUSIONS:

SDB of any severity was associated with poorer behavior but not cognitive performance. The lack of significant cognitive impairment in this age group may have identified a "window of opportunity" where early treatment may prevent deficits arising later in childhood.

Link to abstract here