Sleep Apnea and Snoring in Children Linked to Behavioural Problems

Children with night-time breathing problems such as snoring or sleep apnea are more likely to develop behavioural problems such as hyperactivity, anxiety or aggressiveness and have problems with peer relationships, according to a new study in Pediatrics.

Children with "sleep-disordered breathing" such as snoring and sleep apnea were 40 percent to 100 percent more likely to develop behavioural issues by age 7 than the children who breathed normally through the night, researchers found.

The study surveyed 11,000 children over six years and found nearly over half of the children, 6,000 in total, had breathing disorders during sleep.

"This is the strongest evidence to date that snoring, mouth breathing, and apnea can have serious behavioural and social-emotional consequences for children," Karen Bonuck, lead author and professor of family and social medicine at Albert Einstein College of Medicine at Yeshiva University, said in a statement.

"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," she said.

Sleep apnea and snoring decrease oxygen levels and increase carbon dioxide levels in the brain, according to the study.

The imbalanced brain chemistry interrupts the restorative process of sleep and leads to an inability to regulate emotion and impairs the ability to pay attention, plan ahead and organize, researchers said.

"We are sleeping to restore our brains, and sleep-disordered breathing interferes with that process," Bonuck reported. "For kids, these are critical periods in brain development."

Researchers saw symptoms of sleep-disordered breathing appear as early as 6 months in some children. Children who presented symptoms while very young, were between 40 and 50 percent more likely to experience behavioural problems.

"Although snoring and sleep apnea are relatively common in children, pediatricians and family physicians do not routinely check for sleep-disordered breathing," Bonuck said in a statement.

"In many cases, the doctor will simply ask parents, 'How is your child sleeping?' Instead, physicians need to specifically ask parents whether their children are experiencing one or more of the symptoms of SDB, i.e. snoring, mouth breathing or apnea." she said.

About one in 10 children snore regularly and 2 to 4 percent have sleep apnea, according to the American Academy of Otolaryngology-Head and Neck Surgery.

The journal Pediatrics published the study on Monday 5th March 2012.

People with sleep apnea take abnormally long pauses between breaths in their sleep. The pauses can last up to several minutes and may occur up to 30 times per hour, forcing them to wake up often during the night to take a breath, according to the National Heart Lung and Blood Institute (NHLBI), a division of the U.S. Department of Health and Human Services.

Sleep apnea can cause frequent headaches and mood swings and if left untreated increases the risk of heart attack, stroke and diabetes, according to the NHLBI. Enlarged tonsils, also commonly cause sleep-disordered breathing.

Being overweight is one of the largest risk factors for sleep apnea and snoring, according to the NHLBI. Losing weight helps to reduce the effects.

Other treatment for sleep-disordered breathing includes the use of a Continuous Positive Airway Pressure (CPAP) machine. A CPAP machine consists of a mask that fits over the user's mouth and/ or nose and blows air continuously into the throat, keeping the airway open and allowing the user to breathe easier.

Surgery is sometimes performed to remove excess tissue in the mouth and throat to reduce symptoms.

US Healthcare costs related to Sleep Apnea costs about $1,336 per year, for a total of $3 billion annually, according to a 1999 study published in the journal Sleep.