Study: Snoring in children linked to brain changes, behavior problems

April 13 (UPI) -- Children who snore regularly show signs of structural changes in their brains that perhaps contribute to symptoms such as trouble focusing, hyperactivity and learning difficulties at school, an analysis published Tuesday by Nature Communications found.

Based on reports from parents, children who snored during sleep three or more times per week tended to have thinner gray matter in several regions in the frontal lobes of their brains, the researchers said.

These brain regions are responsible for higher reasoning and impulse control, and the thinner gray matter was linked to behavioral disturbances associated with sleep disordered breathing, a mild form of sleep apnea, they said.

This is because the snoring condition causes disrupted sleep throughout the night due to interrupted breathing and reduction in oxygen supply to the brain, according to the researchers.

"If you have a child who is snoring more than twice a week, that child needs to be evaluated," study co-author Dr. Amal Isaiah said in a press release.

"We now have strong structural evidence from brain imaging to reinforce the importance of diagnosing and treating sleep disordered breathing in children," said Isaiah, an associate professor of head and neck surgery and pediatrics at the University of Maryland School of Medicine in Baltimore.

Up to 10 percent of children in the United States have obstructive sleep disordered breathing, a potentially serious sleep disorder in which the function of the upper airway -- just beyond the mouth and nose -- is obstructed, and breathing repeatedly stops and starts, researchers estimate.

During sleep, this obstruction manifests itself as snoring, and many of those suffering from the condition experience poor sleep quality as a result, according to the Sleep Foundation.

In children, obstructive sleep disordered breathing can be treated with a tonsillectomy and adenoidectomy, which is the surgical removal of tonsils and adenoids at the back of the nose and throat.

Because poor sleep can cause daytime fatigue, which in turn can lead to difficulties concentrating, a significant percentage of children with obstructive sleep disordered breathing are misdiagnosed with attention-deficit hyperactivity disorder and are treated with stimulant medications that can further affect sleep, the researchers said.

For this study, the researchers examined brain magnetic resonance imaging scans collected from more than 10,000 children age 9 to 10 enrolled in the Adolescent Brain Cognitive Development study, long-term research of brain development and child health.

About 16% of the children in the study were obese, or severely overweight, a condition that has been linked with sleep disorders such as obstructive sleep disordered breathing, the researchers said.

Among the study participants, just under 7% were reported by their parents as habitual snorers, meaning they snored two or more nights per week. Nearly 17% of the children exhibited problems behaviors such as anxiety and aggression as well as thinking and attention issues.

Children who were habitual snorers and likely suffering from obstructive sleep disordered breathing had evidence of thinner gray matter on brain MRIs, and were up to three times as likely to experience these behavioral problems, the researchers said.

"These brain changes are similar to what you would see in children with attention deficit hyperactivity disorder," Isaiah said.