Researchers from the Albert Einstein College of Medicine at Yeshiva University in the United States analysed the combined effects of snoring, aponea-abnormal pauses in breathing, and mouth-breathing patterns of children from the Avon Longitudinal Study, which tracked the long-term health and well-being of 14,000 children born in England in 1991 and 1992.
Parents were asked to fill out questionnaires about their children’s sleep-disordered breathing at various intervals, from six- to 69-months-old. They were also asked to complete a strengths and difficulties questionnaire, used to assess behaviour, when their children were around four- and seven-years-old.
Sleep-disordered breathing (SDB) is a term used to describe breathing difficulties that occur during sleep such as snoring and sleep aponea.
According to the American Academy of Otolaryngology Health and Neck Surgery, one in children snore regularly and two to four per cent have sleep aponea.
The findings revealed that children with sleep disordered breathing (SDB) were 40 to 100 per cent more likely to develop behavioural problems such as hyperactivity and aggressiveness at age seven, compared with children without breathing problems.
Children with SDB also had an increased risk of having impaired executive functioning- the ability to pay attention, plan ahead and organise, along with experiencing emotional symptoms and difficulty with peer relationships.
Those whose symptoms peaked early at six or 18 months-old were 40 to 50 per cent more likely to experience behavioural problems as they got older. Sleep disordered breathing normally peaks in children between two and six years old.
The researchers believe SDB causes behaviour problems as it affects the brain because oxygen levels are decreased and carbon dioxide levels are increased, which interrupts the process of sleep.
Ronald Chervin, one of the authors of the study, said, ‘Until now, we really didn’t have strong evidence that SBD actually preceded problematic behaviour such as hyperactivity.
‘Previous studies suggesting a possible connection between SDB symptoms and subsequent behavioural problems weren’t definitive, since they included only small numbers of patients, short follow-ups of a single SDB symptom, or limited control of variables such as low birth weight that could skew the results. But this study shows clearly that SDB symptoms do precede behavioural problems and strongly suggests that SDB symptoms are causing those problems.’
The study, ‘Sleep-Disordered Breathing in a Population-Based Cohort: Behavioral Outcomes at 4 and 7 Years’, is published online in the journal Pediatrics.
