Nova
08-21-06, 12:34 AM
http://www.world-science.net/othernews/050702_snorefrm.htm
Snoring now, hyperactive later ?
Courtesy University of Michigan Health System and World Science staff
Several years ago, researchers found that children who snore when they sleep are far more likely to have attention and hyperactivity problems than those who don’t.
Now, that link has taken on a long-term dimension.
A new survey of the same children shows those who snored regularly then, were about four times more likely than others to develop new hyperactivity within four years, researchers say.
Thus, snoring early in life predicted new or worsened behavior problems later, said the University of Michigan scientists, who conducted both studies. The new results appear in this month’s issue of the research journal Sleep.
Similar behavior was seen among children who had displayed symptoms of obstructive sleep apnea, in which repeated pauses in breathing disrupt sleep, the researchers said. This condition can reduce oxygen levels in the blood.
For example, children with daytime sleepiness in the original study were also more likely to have developed hyperactivity four years later, the researchers explained.
The scientists said the findings held up after they took into account which children already had been identified as hyperactive during the first study, and which ones were taking prescription behavior medicines at follow-up time.
In fact, said lead author Ronald D. Chervin, inattention and hyperactivity in the follow-up study were usually predicted better by snoring and other sleep apnea symptoms four years earlier than by those same symptoms at follow-up time.
One group, boys under age 8 who had the worst sleep-breathing problems during the first study, were about nine times more likely to have new hyperactivity four years later than boys the same age who hadn’t had such sleep problems, the researchers said.
The results are from a study of 229 children who are now between the ages of 6 and 17. The children were drawn from the group of 866 2- to 13-year-olds whose parents were originally surveyed in the late 1990s, in the waiting rooms of several community-based pediatrics clinics.
The parents agreed to allow the researchers to mail them a follow-up survey four years later; 229 returned it. The follow-up group was “statistically comparable” to the initial group, the researchers added.
In both studies, the parents filled out questionnaires assessing their child’s behavior and sleep. Children were encouraged to help their parents with the questionnaires.
The initial study, published in March 2002 in the journal Pediatrics, found that kids who snored regularly were twice as likely as non-snorers to have hyperactivity or attention problems at the same time. Among boys under the age of 8, the rate was four times.
“To our knowledge, this new study is the first long-term, prospective research to show that regular snoring and other clues to the possible presence of sleep apnea predict future development of inattention and hyperactivity,” said Chervin.
“These findings strengthen the hypothesis that untreated sleep-breathing problems in childhood can contribute to the development of hyperactivity.”
Sleep and breathing researchers have found increasing evidence on this issue in recent years, Chervin and colleagues said. The sleep-behavior link rests on the concept that snoring, sleep apnea and other breathing problems during sleep diminish the quality of sleep, repeatedly reduce oxygen levels, and affect daytime behavior.
Data from small groups of children who were treated for sleep-breathing problems—usually by tonsil and adenoid removal—suggest behavior improve as sleep does, Chervin explained.
Larger studies on such children are underway.
But proof that breathing problems during sleep affect daytime behavior is still elusive, the authors wrote. A long-term randomized controlled trial, the gold standard of medical research, might never be done to prove it, because it would require researchers to withhold treatment that is an accepted standard of care.
But the new paper is the first to show that sleep problems come before hyperactive behavior, and that one predicts the other, the researchers said.
“In research, a prospective study that follows a group over time and assesses them at two or more time points carries more weight than one that looks for risk factors and possible outcomes all at the same time,” says Chervin. “That’s what we set out to achieve, and we believe we’ve shown a clear predictive link.”
Chervin and his colleagues said a further prospective study is needed to confirm their results and compensate for some of their study's limitations.
The research focused on a mild to moderate level of hyperactivity, and it’s not certain whether the findings would apply to children with full Attention Deficit/Hyperactivity Disorder, they said.
Until such studies can be done, he says, parents should pay attention to their children’s sleep—and their own.
“Sleep problems in both children and adults are often undiagnosed, even though they can have a major impact on health, behavior and quality of life,” he said. “Getting enough sleep, adopting good sleep habits, and seeking medical attention for issues such as habitual snoring, daytime sleepiness and the breathing interruptions of sleep apnea can have a huge impact on the life of a child or adult.”
People interested in more information can contact the National Sleep Foundation, www.sleepfoundation.org (http://www.sleepfoundation.org/), the researchers said.
Snoring now, hyperactive later ?
Courtesy University of Michigan Health System and World Science staff
Several years ago, researchers found that children who snore when they sleep are far more likely to have attention and hyperactivity problems than those who don’t.
Now, that link has taken on a long-term dimension.
A new survey of the same children shows those who snored regularly then, were about four times more likely than others to develop new hyperactivity within four years, researchers say.
Thus, snoring early in life predicted new or worsened behavior problems later, said the University of Michigan scientists, who conducted both studies. The new results appear in this month’s issue of the research journal Sleep.
Similar behavior was seen among children who had displayed symptoms of obstructive sleep apnea, in which repeated pauses in breathing disrupt sleep, the researchers said. This condition can reduce oxygen levels in the blood.
For example, children with daytime sleepiness in the original study were also more likely to have developed hyperactivity four years later, the researchers explained.
The scientists said the findings held up after they took into account which children already had been identified as hyperactive during the first study, and which ones were taking prescription behavior medicines at follow-up time.
In fact, said lead author Ronald D. Chervin, inattention and hyperactivity in the follow-up study were usually predicted better by snoring and other sleep apnea symptoms four years earlier than by those same symptoms at follow-up time.
One group, boys under age 8 who had the worst sleep-breathing problems during the first study, were about nine times more likely to have new hyperactivity four years later than boys the same age who hadn’t had such sleep problems, the researchers said.
The results are from a study of 229 children who are now between the ages of 6 and 17. The children were drawn from the group of 866 2- to 13-year-olds whose parents were originally surveyed in the late 1990s, in the waiting rooms of several community-based pediatrics clinics.
The parents agreed to allow the researchers to mail them a follow-up survey four years later; 229 returned it. The follow-up group was “statistically comparable” to the initial group, the researchers added.
In both studies, the parents filled out questionnaires assessing their child’s behavior and sleep. Children were encouraged to help their parents with the questionnaires.
The initial study, published in March 2002 in the journal Pediatrics, found that kids who snored regularly were twice as likely as non-snorers to have hyperactivity or attention problems at the same time. Among boys under the age of 8, the rate was four times.
“To our knowledge, this new study is the first long-term, prospective research to show that regular snoring and other clues to the possible presence of sleep apnea predict future development of inattention and hyperactivity,” said Chervin.
“These findings strengthen the hypothesis that untreated sleep-breathing problems in childhood can contribute to the development of hyperactivity.”
Sleep and breathing researchers have found increasing evidence on this issue in recent years, Chervin and colleagues said. The sleep-behavior link rests on the concept that snoring, sleep apnea and other breathing problems during sleep diminish the quality of sleep, repeatedly reduce oxygen levels, and affect daytime behavior.
Data from small groups of children who were treated for sleep-breathing problems—usually by tonsil and adenoid removal—suggest behavior improve as sleep does, Chervin explained.
Larger studies on such children are underway.
But proof that breathing problems during sleep affect daytime behavior is still elusive, the authors wrote. A long-term randomized controlled trial, the gold standard of medical research, might never be done to prove it, because it would require researchers to withhold treatment that is an accepted standard of care.
But the new paper is the first to show that sleep problems come before hyperactive behavior, and that one predicts the other, the researchers said.
“In research, a prospective study that follows a group over time and assesses them at two or more time points carries more weight than one that looks for risk factors and possible outcomes all at the same time,” says Chervin. “That’s what we set out to achieve, and we believe we’ve shown a clear predictive link.”
Chervin and his colleagues said a further prospective study is needed to confirm their results and compensate for some of their study's limitations.
The research focused on a mild to moderate level of hyperactivity, and it’s not certain whether the findings would apply to children with full Attention Deficit/Hyperactivity Disorder, they said.
Until such studies can be done, he says, parents should pay attention to their children’s sleep—and their own.
“Sleep problems in both children and adults are often undiagnosed, even though they can have a major impact on health, behavior and quality of life,” he said. “Getting enough sleep, adopting good sleep habits, and seeking medical attention for issues such as habitual snoring, daytime sleepiness and the breathing interruptions of sleep apnea can have a huge impact on the life of a child or adult.”
People interested in more information can contact the National Sleep Foundation, www.sleepfoundation.org (http://www.sleepfoundation.org/), the researchers said.