Sleep Apnea Linked to Hyperactivity in Youth

ADHD and troubled behavior risks increase with sleep apnea

/ Author:  / Reviewed by: Chris Galloway, M.D.

(RxWiki News) Children who have issues with sleep—whether it is too much or too little—need their problems addressed in order to prevent disruptions during the day, studies suggest.  

According to researchers at Albert Einstein College of Medicine, troubled breathing during sleep affects children as young as six months.

Moreover these issues drastically increase the chances a child will develop behavioral problems, such as aggressiveness, hyperactivity and inattentiveness.

The study investigated over 11,000 children and found those with sleep-disordered breathing were 40 to 50 percent more likely to be affected in mood and actions.

"Talk to a pediatrician about your child's troubled sleep."

"This is the strongest evidence to date that snoring, mouth breathing, and apnea [long pauses in breath during sleep] can have serious behavioral and social-emotional consequences for children," says lead author and professor Karen Bonuck, PhD.

"Parents and pediatricians alike should be paying closer attention to sleep-disordered breathing in young children, perhaps as early as the first year of life."

Dr. Bonuck and her coworkers believe that sleep-disordered breathing deprives the brain of oxygen while increasing carbon dioxide levels, which would interrupt the processes of restorative sleep.

Interruptions in this deep sleep can create a cellular and chemical imbalance in the brain, which in turn causes children to have trouble concentrating, regulating emotion, and engaging in activities that would come easy for those who sleep well.

Their investigation analyzed the effects of multiple sleep breathing patterns, such as sleep apnea and snoring, using data gathered from the Avon Longitudinal Study of Parents and Children.

The study followed tens of thousands of mothers and their children from birth onward, and parents were required to complete questionnaires regarding their child’s sleep-breathing symptoms as part of it.

The forms analyzed the kids from six months to almost six years old, and a subsequent Strengths and Difficulties Questionnaire (SDQ) gathered their behavioral profiles between ages four and seven. The SDQ measured for attention deficits, hyperactivity, mood fluctuations, issues with peers, behavioral outbursts and their ability to share or help others.

Bonuck notes, “We found that children with sleep-disordered breathing were from 40 to 100 percent more likely to develop neurobehavioral problems by age 7, compared with children without breathing problems.” While hyperactivity was most commonly correlated, problems were found in all areas of behavior reported in the SDQ.

Co-author on the study, Ronald Chervin, MD, explains that this is the strongest evidence to date that sleep issues come before problem behavior. “Previous studies suggesting a possible connection between sleep-disordered breathing symptoms and subsequent behavioral problems weren't definitive, since they included only small numbers of patients, short follow-ups of a single sleep-disordered breathing symptom, or limited control of variables such as low birth weight that could skew the results,” he says.

“But this study shows clearly that sleep-disordered breathing symptoms do precede behavioral problems and strongly suggests that sleep-disordered breathing symptoms are causing those problems."

The research is published in today’s issue of Pediatrics, supported by grants from the National Institute of Health. No conflicts of interest were reported.

Reviewed by: 
Review Date: 
March 5, 2012
Last Updated:
October 4, 2012