Sleep Problems May Affect Kids' Behavior
< Mar. 07, 2012 > -- Snoring can disrupt sleep, and when that disruption happens in kids, they can develop behavioral problems.
That's the conclusion of a new study published online this week in the journal Pediatrics.
Infants and toddlers who snored or had other breathing problems during sleep were more likely by age 7 to be hyperactive or have difficulties with inattention, anxiety, depression, aggressiveness, and conduct issues.
Researchers at Albert Einstein College of Medicine in New York City followed 11,000 children in England for six years. Children were enrolled in the study at 6 months of age. The researchers asked parents to evaluate their child's sleep breathing patterns, noting if a child snored, breathed through the mouth, or had sleep apnea.
Parents also filled out questionnaires about their child's behavior at ages 4 and 7 years old.
Children who had the worst sleep-disordered breathing were almost twice as likely to have behavioral issues at age 7 as kids whose breathing was normal. Children were considered to have behavioral problems if their parent's ratings were in the top 10 percent, relative to kids their age, for problem behaviors.
By age 7, kids with "worst" sleep-breathing problems were 85 percent more likely to be hyperactive, about 60 percent more likely to have emotional or conduct problems, and nearly 40 percent more likely to have peer difficulties.
Children whose symptoms peaked at 6 months or 18 months were 40 to 50 percent more likely to have behavioral problems at age 7, compared with children who breathed normally.
Results in agreement
Heidi Connolly, M.D., at the University of Rochester Medical Center in New York, says the study adds to a growing body of research showing that snoring, mouth breathing, and sleep apnea in children should be taken seriously.
"These findings echo many of the other studies that show having sleep apnea and symptoms of snoring are bad for neurodevelopmental outcomes in children," Dr. Connolly says.
The researchers say that behavioral problems may occur for several reasons. By interfering with the quality of rest, sleep-disordered breathing leaves kids overtired. That may contribute to behavioral issues, such as being easily distracted, hyperactivity, and irritability.
Effect on brain
Previous research has also suggested that sleep-disordered breathing affects brain physiology by limiting the amount of oxygen reaching the brain and allowing carbon dioxide to build up, says study author Karen Bonuck, Ph.D.
"We are sleeping to restore our brains, and sleep-disordered breathing interferes with that process," Dr. Bonuck says. "For kids, these are critical periods in brain development."
Snoring occurs when the palate and the base of the tongue vibrate against each other. In sleep apnea, the airway is blocked. When kids try to breathe, negative pressure squeezes the airway shut. That causes kids to wake up partially to take a breath.
Obesity is a major risk factor for sleep apnea in children, but normal-weight kids can develop it, too.
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How Much Sleep?
Children have different sleep needs, depending on their age:
3 to 5 years old. Preschoolers need 11 to 13 hours of sleep each day. Kids at this age often have difficulty falling asleep and staying asleep, the National Sleep Foundation (NSF) says. They are more likely to have nightmares and sleep terrors, and to sleepwalk.
School-age. Children in elementary school need 10 to 11 hours of sleep each day. Schoolchildren spend time with TV, computers, and the Internet, all of which can erode time for sleep. This age group also may be drinking caffeinated beverages, which can affect how easily they fall asleep at night.
Teens. Teens should get 8.5 to 9.5 hours of sleep each day. A teen's internal clock usually resets itself. That creates a biological desire to stay up later and sleep later.
Always talk with your health care provider to find out more information.
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American Academy of Pediatrics - Sleep Apnea Detection
National Sleep Foundation - Could My Child Have Sleep Apnea?
Pediatrics - Sleep-Disordered Breathing in a Population-Based Cohort