When Little Ones Snore at Night

Sleep disordered breathing in children may contribute to behavioral problems

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Kids' snores may seem cute, but they may be a sign of certain problems. Children with breathing difficulties during sleep might have difficulties in the daytime too.

A recent study looked at the link between behavior difficulties and breathing problems during sleep.

The researchers found that children with abnormal breathing at night showed a much higher risk for behavior problems than children with normal sleep.

The children with nighttime breathing problems also scored high on tests showing symptoms for social and communication problems.

Parents of children with breathing difficulties may want to seek treatment for these issues.

"Ask a pediatrician about your child's sleep-disordered breathing."

The study, led by Michelle M. Perfect, PhD, of the Department of Disability and Psychoeducational Studies at the University of Arizona in Tucson, looked at behavioral issues in children with sleep-disordered breathing.

Sleep-disordered breathing refers to a number of possible conditions that involve abnormal breathing during sleep, such as sleep apnea and snoring.

For the long-term study, 263 children underwent sleep studies twice about five years apart. The participants were between 6 and 11 years old when the study began, and they underwent assessments regarding their neurology and behavior.

The researchers found that children with a history of sleep-disordered breathing were just over three times more likely to score high on the assessments showing externalizing problems than children with no history of sleep-disordered breathing.

Externalizing problems refer to behavior issues like acting out, aggression, rule-breaking and hyperactivity. Internalizing refers to issues like depression, anxiety and antisocial behavior.

The children with sleep-disordered breathing were also nearly seven times more likely than those without the condition to score high on an assessment related to symptoms of problem behaviors and on another related to hyperactivity.

These results mean that those children tended to exhibit a higher number of behavior problem symptoms and hyperactive symptoms than children whose sleep studies indicated they were breathing normally during sleep.

The children with sleep-disordered breathing were also three times more likely to score high on a test that looked at difficulties with social interactions. They were over four times more likely to show difficulties in communication or taking care of themselves.

Even children who showed sleep-disordered breathing during the second sleep study but not during the first were about three times more likely to have difficulty with adaptation behavior skills, compared to children who never had sleep-disordered breathing.

"Youth with current sleep-disordered breathing exhibited hyperactivity, attention problems, aggressivity, lower social competency, poorer communication and/or diminished adaptive skills," the researchers concluded. "Overall, the current study underscored the associated risks of sleep-disordered breathing being left untreated."

William Kohler, MD, the Director of Pediatric Sleep Services at Florida Hospital Tampa and a dailyRx expert, said this article adds to existing research that shows sleep-disordered breathing can have significant consequences for children's behavior and adaptive functioning.

"Snoring is not a joke. Any child that has recurrent snoring should be evaluated for a potential significant sleep problem," Dr. Kohler said. "The diagnosis of the underlying problem should be made early while remediation can be still be effective. Previous studies have shown that there may be irreparable damage done if the underlying sleep problem is not corrected early enough."

A variety of treatments address sleep-disordered breathing, including continuous positive airway pressure (CPAP) in those with obstructive sleep apnea and adenotonsillectomy in younger patients. An adenotonsillectomy is a surgery to remove a person's tonsils and adenoids.

The study was published in the April issue of the journal Sleep. The research was funded by the National Institutes of Health. The authors declared no conflicts of interest.

Reviewed by: 
Review Date: 
April 3, 2013
Last Updated:
August 15, 2013