Snoring And Sleep Apnea Increase Children’s Risk Of Behavioral Problems
According to a study conducted by researchers at Albert Einstein College of Medicine of Yeshiva University, children who experiment breathing disorders during sleep also have behavioral problems. The study, conducted on a sample of 11,000 children over 6 years, was published in the journal Pediatrics. Study leader, Karen Bonuck, Ph.D, professor of family,social medicine, obstetrics & gynaecology and women’s health at Einstein, underlines the importance of the problem in children and points out that both pediatricians and obstetricians should carefully monitor these children.
Breathing difficulties usually occur in children aged between 2 and 6 years, but can also occur in children younger than 2 years. Children who snore or have sleep apnea episodes, (stop breathing during sleep), usually have enlarged tonsils or nasal polyps. According to the American Academy of Otolaryngology-Health and Neck Surgery (AAO-HNS), 1 in 10 children snore regularly and 2 to 4% have episodes of apnea. Previous studies have reported the link between SDB (sleep-disordered breathing) and behavioral disorders in children but they were somehow questionable due to the small sample used and short follow-up period. The current study clearly demonstrates that behavioral disorders, such as hyperactivity, aggressiveness, difficulties in communicating with their peers, are caused by SDB.
Researchers analyzed questionnaires completed by parents regarding symptoms and behavior of their children. It was found that behavioral problems usually begin at the age of 7 years, and the main symptom of these children with SDB is hyperactivity. Researchers think that SDB cause behavioral disorders because the brain is affected: SDB not only prevents the child to rest properly, which explains the effects on memory and attention during the day, but also disturbs the balance between various processes and biochemical mechanisms of the prefrontal cortex. All these imbalances are reflected in the behavior of the child. This is way the child is not careful, not willing to listen, and cannot control his emotions and impulses.
Dr. Bonuck remarks that although snoring and sleep apnea are relatively common among children, pediatricians do not usually check if the child does indeed have SDB. In order to help the children not to develop behavioral problems, pediatricians should ask the parents if the child has any specific symptoms of SDB, that is snoring, open mouth breathing or sleep apnea.
Underlying causes of SDB can be fixed surgically. Tonsillectomy and nasal polypectomy are surgeries performed under local or general anesthesia of short duration with a minimal recovery period. In obese children, doctors recommend weight loss to relieve their breathing disorders during sleep, but also prevent any long-term complications of obesity.