Behavioral issues in children could be linked to snoring

If you’ve ever lived with a person who snores, you know the noise can be enough to keep you up at night. It’s an annoyance for sure, but new research shows that when young children snore it could lead to more serious behavioral and emotional problems.

A new study, published in the journal Pediatrics, shows that young children who have sleep-disordered breathing (snoring or other breathing issues during sleep) could be more likely to develop conditions like attention-deficit/hyperactivity disorder or anxiety by the time they’re seven years old. The study followed 13,000 children, from infancy to the age of 7, and found that those who snored or had some form of breathing problem while asleep were far more likely to develop behavioral or emotion problems than children who had no breathing issues while asleep.

So how are the two related? The answer is going to be different for each child, but it often comes down to how a child’s nighttime breathing affects his rest.

“When you have sleep-disordered breathing, you wake up momentarily when your breathing drops,” says Sanjeev Kothare, MD, interim medical director of the Center for Pediatric Sleep Disorders at Children’s Hospital Boston. “So if a child is waking up 50 times a night he’s not getting the proper amount of rest, and that could manifest itself in hyperactivity or other behavioral problems.”

Sanjeev Kothare, MD

When you sleep, your tongue and the muscles in your throat relax, causing your airway to narrow. This can be problematic for kids between the ages of 3 and 6, because tonsils go through a growth spurt at that age; if the tonsils grow bigger before the throat has time to catch up, it can lead to airway blockage during sleep. When oxygen levels drop too low, the body will automatically wake up, interrupting the child’s much-needed sleep time. In addition to compromising sleep, a lack of oxygen is also tied to a loss of memory and cognitive function. This means that kids with serious sleep-disordered breathing aren’t just being deprived of rest at night, but of oxygen too; both of which can impact their behavior when awake.

The good news is that when problematic sleep-disorder breathing is identified early, it can be treated before it has time to affect a child’s behavior. Kothare suggests that all parents monitor their children’s breathing during sleep, sporadically checking on them and listening to their breathing pattern. Things to look for:

  • Does the child snore?
  • Is the snoring accompanied by pauses in breathing?
  • Does the child breath through his nose or mouth when asleep?
  • Does he wake up with a dry mouth?

“If the child snores but doesn’t appear to be pausing his breath or having problems when he wakes up the following day, there’s little to worry about,” says Kothare. “He could just be a healthy, habitual snorer.”

If your child has sleep-disordered breathing a sleep study can help identify its cause and improve treatment.

But if two or more of these criteria apply to your child, or he often seems agitated or tired after a full night’s rest, you should bring it up with his pediatrician who may recommend a visit with a pediatric sleep physician. Evaluation by the specialist is likely to involve a sleep study to discover exactly what’s causing the child’s breathing difficulty. Depending on the findings, further consultation with an otolaryngologist (ear, nose and throat doctor) could be needed. In some cases the child may need an adenotonsillectomy (having the adenoids and tonsils removed), which would cure or significantly reduce the sleep apnea and improve the child’s sleep as well as daytime behavior.

If you have questions about your child’s sleep breathing Dr. Kothare can be reached at 781-216-2570. To speak with another member of his team, please contact Children’s Center for Pediatric Sleep Disorders or call 781-216-2570.