Brain changes, behavioral issues discovered in children who regularly snore

BALTIMORE, Md. — A good night’s sleep is key for any growing child. While some kids may being getting enough rest, the quality of their sleep is a whole different issue. Researchers find children who snore regularly don’t just suffer from interrupted sleep, the problem may affect their brains as well.

A team from the University of Maryland School of Medicine (UMSOM) say they have discovered structural changes in the brains of children who snore often. These changes show a connection to behavioral problems such as lack of focus, hyperactivity, and learning difficulties at school.

How does snoring damage the brain?

Study authors examined MRI scans from over 10,000 children between ages nine and 10. All of the youths are enrolled in the Adolescent Brain Cognitive Development (ABCD) study, the largest long-term study of brain development and child health in America. For this study, the parents of the children involved reported on their snoring habits.

The results show that kids who snore more than three times a week are more likely to have thinner gray matter in multiple regions of the brain’s frontal lobes. These areas are responsible for higher reasoning and impulse control. Study authors say the thinner brain matter in these regions also connects with behavioral issues related to sleep disordered breathing. Doctors refer to the severe form of this condition as sleep apnea.

In these children, snoring can cause disrupted sleep throughout the night due to interruptions in their breathing. This reduces the oxygen supply to the brain.

“This is the largest study of its kind detailing the association between snoring and brain abnormalities,” explains study lead author Amal Isaiah, MD, PhD, Associate Professor of Otorhinolaryngology-Head and Neck Surgery and Pediatrics at UMSOM in a media release. “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.”

Children with sleeping issues may be getting the wrong diagnosis

Up to 10 percent of children in the U.S. may be dealing with obstructive sleep disordered breathing. Unfortunately, researchers believe doctors may be misdiagnosing many of these cases as ADHD and prescribing patients stimulant medications.

“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,” Dr. Isaiah says.

Study authors add that the best way to treat the condition is by a tonsillectomy and adenoidectomy. These are the typical methods for alleviating snoring, breathing pauses, and mouth breathing in children.

“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,” says study co-author Linda Chang, MD, MS, a co-principal investigator on the ABCD study.

Scientists are planning a follow-up study to see if children who continue snoring display worsening brain scans later on.

“For the first time, we see evidence on brain imaging that measures the toll this common condition can take on a child’s neurological development,” concludes E. Albert Reece, Executive Vice President for Medical Affairs at UM Baltimore. “This is an important finding that highlights the need to properly diagnose snoring abnormalities in children.”

The study appears in the journal Nature Communications.

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