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Children who snore or who have other sleep-related breathing problems in the first years of life are more likely to have behavioral problems years later, according to new research. Addressing these problems early may prevent adverse behavioral outcomes.
Parents participating in the large, population-based Avon Longitudinal Study of Parents and Children completed questionnaires on their child’s sleep-disordered breathing symptoms (ie, snoring, apnea, and mouth breathing) when the children were 6, 18, 30, 42, 57, and 69 months. When the children were approximately 4 and 7 years, parents completed the Strengths and Difficulties Questionnaire (SDQ), rating behavioral and emotional problems. Children in the upper 10% of total SDQ scores at 4 and 7 years had significantly more adverse characteristics than the remaining 90% of the study sample.
By 4 years, children with sleep-disordered breathing were approximately 20% to 60% more likely to have behavioral difficulties, and by 7 years, these children were 40% to 100% more likely to have hyperactivity and other behavioral difficulties. Children with the worst breathing symptoms also had the worst behavioral outcomes. Hyperactivity was the most affected of the neurobehavioral domains evaluated. The effects of sleep-disordered breathing persisted even after controlling for potential confounding factors such as maternal age, smoking, and education.
Even children whose symptoms peaked at 6 and 18 months and then abated had increased behavioral problems at 7 years. The researchers say this suggests that there is increased vulnerability to the effects of sleep-disordered breathing during an early critical period of brain development when the need for sleep is greatest. Symptoms of sleep-disordered breathing may require attention as early as the first year of life.