Little Snorers Can Have Big Behaviors

Snoring in children linked to behavior and attention problems

(RxWiki News) It may seem cute sometimes when babies snore, like their adorable yawns and sneezes. But persistent snoring in children may be a sign of later behavior problems.

A recent long-term study has confirmed the link that other studies have already found between snoring and a greater risk of attention problems and behavioral difficulties.

"Tell your pediatrician if your child snores."

The study was led by Dean W. Beebe, PhD, of the Division of Behavioral Medicine and Clinical Psychology at Cincinnati Children’s Hospital Medical Center and the Department of Pediatrics at the University of Cincinnati College of Medicine.

Dr. Beebe and colleagues followed 249 pairs of mothers and their children from the children's birth. They classified the children into one of three categories based on parents' reports.

If they snored loudly more at least twice a week at 2 and 3 years old, they were classified as persistent snorers. If they snored two or more times a week at age 2 or age 3 - but not at both ages - they were called "transient snorers."

If they didn't snore at least twice a week at any age, they were classified as non-snorers. Among the 249 children, 68 percent were non-snorers, 23 percent were transient snorers and 9 percent were persistent snorers.

The researchers had the parents fill out a variety of psychological assessments about their children that help measure children's behavior and their cognitive and motor development.

They also gathered information on the children's race/ethnicity, gender, socioeconomic status, birth weight, current weight, exposure to tobacco while their mother was pregnant, exposure to tobacco after birth, whether the child was breastfed and how long the child was breastfed.

The researchers found that the children who snored loudly at ages 2 and 3 were more likely to have behavior problems and especially to experience hyperactivity, depression or problems with attention.

The children in the non-snoring group tended to have better scores on the cognitive tests, but after the researchers took the other demographic information into account, the differences in scores was no longer significant.

Children from families with lower incomes and children who were not breastfed or who weren't breastfed very long were more likely to be persistent snorers. African-American children were also more likely to be snorers.

The findings regarding tobacco exposure were a little more complicated. There appeared to be behavioral problems among children exposed to tobacco in the womb, but these vanished when the researchers controlled for other factors.

Meanwhile, non-African-American children (94 percent were white) who were exposed to tobacco in the home were slightly more likely to snore sometimes or persistently.

None of the other factors they studied - including the children's weight - appeared to play a part in determining the likelihood that a child would snore.

The results did not show that snoring causes behavioral problems. It did show that the two are linked, but these results match up with animal studies in which scientists were able to determine that sleep problems or difficulty breathing during sleep caused behavioral changes in animals.

Other studies are looking at possible solutions for snoring and whether surgery to stop snoring has an impact on behavior, but the results are not available yet.

The authors wrote that their findings highlight the importance of screening children for snoring.

"It is important to ask specifically about snoring, because parents’ responses to more general sleep questions may not reflect this hallmark symptom of sleep-disordered breathing," they wrote. They added that screening children from lower income levels is especially important.

"A lot of kids snore every so often, and cartoons make snoring look cute or funny. But loud snoring that lasts for months is not normal, and anything that puts young kids at that much risk for behavioral problems is neither cute nor funny," says Dr. Beebe. "That kind of snoring can be a sign of real breathing problems at night that are treatable. I encourage parents to talk to their child's doctor about loud snoring, especially if it happens a lot and persists over time."

The study was published August 13 in Pediatrics. The study was funded by grants from the National Institute of Environmental Health Sciences and the National Institutes of Health. The authors declared no conflicts of interest.

Review Date: 
August 11, 2012