Sleep Apnea In Kids Linked To Behavioral Problems

Obstructive sleep apnea, a common type of sleep-disordered breathing (SDB), has been linked to elevated rates of ADHD-like behavioral issues in kids, in addition to learning and adaptive problems.

The findings were published in the journal Sleep and came about after a five-year study which analyzed data from a longitudinal cohort called the Tucson Children's Assessment of Sleep Apnea Study (TuCASA).

The study assessed Caucasian and Hispanic kids ranging in age from 6 to 11 years to measure the incidence and prevalence of SDB and its consequences on neurobehavioral functioning.

Michelle Perfect, PhD, the study's lead author and assistant professor in the school psychology program in the department of disability and psychoeducational studies at the University of Arizona in Tucson, said:

"This study provides some helpful information for medical professionals consulting with parents about treatment options for children with SDB that, although it may remit, there are considerable behavioral risks associated with continued SDB. School personnel should also consider the possibility that SDB contributes to difficulties with hyperactivity, learning and behavioral and emotional deregulation in the classroom."

The study consisted of 263 kids who participated in a sleep study and a neurobehavioral test of assessments which included youth and parent-documented rating scales.

The outcomes revealed that 23 kids had incident sleep apnea that developed during the trial period, while 21 kids had persistent sleep apnea for the entire length of the study. An additional 41 children who started out with sleep apnea stopped having breathing issues during sleep when examined at the five-year follow-up.

In children with incident sleep apnea, the risk of having behavioral issues was four to five times higher. In kids with persistent sleep apnea, that risk was six times higher.

Compared with children who never experienced SDB, those with sleep apnea were more inclined to have parent-documented issues in the areas of:

• attention
• disruptive behaviors
• hyperactivity
• social competency
• self-care
• communication

Kids with persistent sleep apnea were shown to be seven times more likely to have parent-documented learning issues and three times more likely to earn grades of C or under.

Research reported at the 24th annual meeting of the Associated Professional Sleep Societies in 2010, revealed that the academic grades of children with sleep apnea are worse than students who do not have sleep-related breathing problems.

The authors noted that this was the first sleep-related study to utilize a standardized survey to measure adaptive functioning in normal youths with and without SDB.

Perfect concluded, "Even though SDB appears to decline into adolescence, taking a wait and see approach is risky and families and clinicians alike should identify potential treatments."

Sleep apnea is prevalent in approximately two percent of healthy children, according to the American Academy of Sleep Medicine. Sleep apnea in kids of this age is generally due to oversized tonsils and adenoids. Most of these children with sleep apnea also experience loud snoring.

Treatment choices include the removal of the adenoids or tonsils via surgery and the use of continuous positive airway pressure therapy (CPAP).