Snoring, mouth breathing, or apnea early in life may predict later behavioral and emotional problems, researchers found.
Signs of sleep-disordered breathing in children, ages 6 to 69 months, predicted a 60% higher risk of behavioral problems, such as hyperactivity, at age 7, Karen Bonuck, PhD, of Albert Einstein College of Medicine in New York City, and colleagues reported.
The children with the worst symptoms that persisted the longest were most likely to develop hyperactivity, conduct, and social problems in the longitudinal study in the April issue of Pediatrics.
But even the kids whose symptoms resolved after peaking at around 18 months faced a 40% to 50% elevated risk of behavioral problems at age 7 compared with those who never had symptoms.
Sleep-disordered breathing also correlated with anxiety and depression across all the symptomatic groups, with 32% to 65% elevated odds at age 7 (all P<0.01 or P<0.05).
These "findings suggest that sleep-disordered breathing symptoms may require attention as early as the first year of life," the researchers wrote.
What is snoring?
Snoring, like all other sounds, is caused by vibrations that cause particles in the air to form sound waves. For example, when we speak, our vocal cords vibrate to form our voice. When our stomach growls (borborygmus), our stomach and intestines vibrate as air and food move through them.
While we are asleep, turbulent airflow can cause the tissues of the nose and throat to vibrate and give rise to snoring. Essentially, snoring is a sound resulting from turbulent airflow that causes tissues to vibrate during sleep.
How common is snoring?
Any person can snore. Studies estimate that 45% of men and 30% of women snore on a regular basis. Frequently, people who do not regularly snore will report snoring after a viral illness, after drinking alcohol, or when taking some medications.
People who snore can have any body type. We frequently think of a large man with a thick neck as a snorer. However, a thin woman with a small neck can snore just as loudly. In general, as people get older and as they gain weight, snoring will worsen.
That may mean monitoring and treatment such as surgery for the enlarged tonsils and adenoids that typically lead to abnormal breathing during sleep in children, Bonuck explained to MedPage Today.
“There’s no reason for parents to be alarmed,” she said. “Our evidence appears to provide the strongest evidence to date that [sleep disorders] do play a causal role and therefore reducing these symptoms particularly early in life is likely to have some benefit in reducing future problems.”
Snoring, snorting, and mouth breathing
If your sleeping toddler occasionally snores, makes snorting sounds, or breathes through her mouth, it’s probably nothing to worry about, especially if her snores have a steady rhythm. Also, many children snore or breathe through their mouth when they have a stuffy nose due to a cold or allergies.
If you think a stuffy nose is to blame, try using a vaporizer or humidifier to make breathing more comfortable. If your toddler has pet allergies, keeping her bedroom free of pets is one step you can take that may help.
If your toddler snores loudly, pauses between breaths, seems to work hard to breathe, or gasps as she tries to catch her breath, she may have a potentially serious sleep disorder known as sleep apnea. The most common cause of sleep apnea in children is enlarged tonsils or adenoids (the glands in the throat just behind the nose). Other factors include being overweight and having certain facial characteristics, such as a receding chin and cleft palate.
Sleep apnea peaks between the ages of 3 and 6, when the tonsils and adenoids are at their largest in comparison to child-sized airways. But younger children can also have this condition.
Because the condition disrupts sleep, you may notice that your child with sleep apnea tends to be sleepy during the day when she should be alert. She’s also more likely to be cranky and irritable, and she may have behavior problems.
If you think your toddler may have sleep apnea, mention it to her doctor. He can check for problems and may refer you to a specialist - an ear, nose, and throat doctor or a sleep expert - to assess your child’s breathing.
A specialist may suggest removing your child’s tonsils or adenoids - a relatively simple operation that may solve the problem.
If your child’s sleep apnea is caused by her being overweight, the doctor can help you modify your child’s diet.
For clinicians, simply asking, “How is your child sleeping?” isn’t enough, Bonuck argued.
They “need to ask more and better questions about children’s sleep when parents take children in for well visits,” she told MedPage Today, noting that one recent study found that about half of parents see snoring as a sign that their child is sleeping well.
Provided by ArmMed Media
