Why snoring and disrupted sleep are associated with behavioral problems in children?

Why snoring and disrupted sleep are associated with behavioral problems in children?


Children who regularly snore have structural changes in their brain that may account for the behavioral problems associated with the condition including lack of focus, hyperactivity, and learning difficulties at school. That is the finding of a new study conducted by researchers and published in the journal Nature Communications.

To conduct study, the researchers examined MRI images collected from more than 10,000 children aged 9 to 10 years enrolled in the Adolescent Brain Cognitive Development (ABCD) study, the largest long-term study of brain development and child health in the US. UMSOM researchers are co-investigators in this ongoing study.

They found that children who snored regularly (three or more times per week), as reported by their parents were more likely to have thinner gray matter in several regions in the frontal lobes of their brain. These areas of the brain are responsible for higher reasoning skills and impulse control. The thinner cortex in these regions correlated with behavioral disturbances associated with sleep disordered breathing, a severe form of which is called sleep apnea. These behavioral problems include a lack of focus, learning disabilities, and impulsive behaviors. The snoring condition causes disrupted sleep throughout the night due to interrupted breathing and reduction in oxygen supply to the brain.

"This is the largest study of its kind detailing the association between snoring and brain abnormalities," said study lead author. "These brain changes are similar to what you would see in children with attention deficit hyperactivity disorder. Children have loss of cognitive control which is additionally associated with disruptive behavior."

Up to 10 percent of American children have obstructive sleep disordered breathing, and a significant percentage are misdiagnosed as having ADHD and treated with stimulant medications.

The authors offered this advice to parents: "If you have a child who is snoring more than twice a week, that child needs to be evaluated. We now have strong structural evidence from brain imaging to reinforce the importance of diagnosing and treating sleep disordered breathing in children."

The condition can be treated with tonsillectomy and adenoidectomy, considered the first line of treatment of children with symptoms of snoring, breathing pauses during sleep, and mouth breathing.

"We know the brain has the ability to repair itself, especially in children, so timely recognition and treatment of obstructive sleep disordered breathing may attenuate these brain changes. More research is needed to validate such mechanisms for these relationships which may also lead to further treatment approaches," said study co-author.

The researchers plan to conduct a follow-up study to determine whether children who continued to snore experienced worsening brain findings on their MRI.

https://www.nature.com/articles/s41467-021-22534-0

http://sciencemission.com/site/index.php?page=news&type=view&id=publications%2Fassociations-between_4&filter=22

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