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Vincent Iannelli, M.D.

Sleep-Disordered Breathing and Your Child's Behavior

By March 5, 2012

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Pediatricians and parents became more aware of the possible consequences of sleep apnea after the American Academy of Pediatrics released their clinical practice guideline on "Diagnosis and Management of Childhood Obstructive Sleep Apnea Syndrome" in 2002. Those consequences can include poor learning, behavioral problems, and symptoms of attention-deficit/hyperactivity disorder.

A new study that will appear in the April issue of Pediatrics, "Sleep-Disordered Breathing in a Population-Based Cohort: Behavioral Outcomes at 4 and 7 Years," is a good reminder of the importance of identifying and treating children with sleep apnea. The study found that early-life sleep-disordered breathing "had strong, persistent statistical effects on subsequent behavior in childhood."

In the study, children with three of the hallmark symptoms of sleep-disordered breathing, including snoring, mouth breathing, and witnessed apnea, were 20 to 60 percent more likely to have behavioral difficulties by the time they were four years old. This increased to 40 to 100 percent by age seven years.

The study also reinforces the importance of a sleep history screening for snoring at your child's well child visits, including visits before his first birthday. Including a history of nightly snoring, your pediatrician might ask about labored breathing during sleep, observed apnea, restless sleep, diaphoresis (sweating), enuresis (bedwetting), cyanosis, excessive daytime sleepiness, mouth breathing, and hyponasal speech.

How your child snores can also be important. While snoring can sometimes be normal, a child with snoring and sleep-disordered breathing will often have nightly snoring, which may be loud, and instead of being rhythmic, has intermittent pauses, snorts, or gasps.

Does your child have any signs or symptoms of sleep-disordered breathing?

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