In a study that is said to be the largest and most comprehensive of its kind, researchers followed more than 11,000 children in southwest England. The children involved in the study were enrolled while their mothers were still pregnant and all children in the study were born between April 1991 and December 1992.
Over the duration of the study, parents of the children were asked to complete questionnaires that asked about problems with snoring, mouth breathing while sleeping and abnormal pauses while sleeping. The questionnaires were given at six months, 18 months, 30 months, 42 months, 57 months and 69 months of age. At age seven, researchers had parents complete a questionnaire that asked about their child’s behaviors.
According to their results, approximately 45 percent of all of the children surveyed breathed normally while sleeping. Out of the remaining children, the researchers separated children that had elevated levels of all three breathing symptoms at 30 months of age and deemed them as “worst case” children. They then factored in 15 other factors that have been previously linked to behavioral problems, such as low birth weight and the mother’s education level.
After accounting for all factors and compiling the data, researchers found that children with sleep disorders were 40% – 100% more likely to have behavioral problems by the time they reached the age of seven than children that did not have sleep-related disorders. The worse the breathing problems were, the more likely they were to have behavior problems. Behavior problems most commonly noted included hyperactivity, aggression, anxiety, depression and difficulty getting along with peers.
Scientists have a few theories as to why sleep problems may increase the risk of behavioral problems; decreased oxygen to the brain may hinder brain development, the body’s natural method of restoration during sleep may be disrupted, changing chemical and cellular systems in the body – but no one really knows for certain. But no matter what the reason, sleep experts say that parents need to be aware of the connection.
“The takeaway is that parents need to pay closer attention to their child’s breathing while they’re sleeping,” Karen Bonuck, a professor of family and social medicine at Albert Einstein College of Medicine in New York said.
However, Marianne Davey, co-founder of the British Snoring and Sleep Apnea Association, says that parents shouldn’t worry too much, but that they should be aware of the problem and monitor it carefully. She says that sleep problems in children are most commonly caused by an imbalance between the size of the tonsils and adenoids and the child’s airway and that if the problem persists past the age of eight, the child should be seen by a physician.
“It’s a very good study,” Davey said. “It’s alerting us to the fact that children with sleep disorders do tend to get this label of having ADHD wrongly. You don’t want the snoring to go on for too long, because a snoring child will not function very well at school because they’ll be tired. The other side of it is you don’t want to be taking out tonsils and adenoids unnecessarily.”
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