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Snoring Linked to Behavioral Problems Associated with Poor Sleep Quality: Presented at AACAP

By Paula Moyer

MIAMI BEACH, FL -- October 20, 2003 -- Psychiatrists need to inquire whether a child snores habitually when the parent complains of the child's irritability and hyperactivity.

"Children who are habitual snorers are more likely to have these problems, whether or not they have sleep apnoea," said Ayse Rodopman-Arman, MD, assistant professor of medicine, Marmara University Child Psychiatry Clinic, Istanbul, Turkey. "If a parent complains that a child is hyperactive or irritable, ask about snoring. If snoring is a problem, the child should be co-managed by the psychiatrist and by an otorhinolaryngologist."

Dr. Rodopman-Arman presented the findings here October 15^th at the 50^th Anniversary Meeting of the American Academy of Child and Adolescent Psychiatry. She recommended that psychiatrists routinely ask about sleep-related problems with irritable and hyperactive children, including questions about snoring and about daytime somnolence. For example, the physician could ask if the child falls asleep watching television, she said.

She and her colleagues were prompted to conduct the study because of previous findings that 3.2% to 12.1% of children snore habitually. Because both primary snoring and snoring related to sleep apnoea are associated with signs of sleep deprivation, she and her colleagues assessed the prevalence of parasomnias, bedtime behaviors, and activity levels in 802 girls and 838 boys in Istanbul aged from 7 to 11 years.

The investigators initially gave the children's parents a sleep behavior questionnaire to determine the children's bedtime and night time sleep-related behaviors, as well as their daytime somnolence and levels of irritability and hyperactivity. Statisticians analyzed the data with the Chi-square tests.

Parents reported snoring in 42% of the children. In the snoring group, 16.6% reported nightmares, and 8.9% reported that their children were sleepy during class time. Among the snorers, 27.8% were rated as either irritable or hyperactive by their parents. These rates were statistically significantly higher than for the non-snorers (P<0.0001 for nightmares, P<0.002 for daytime somnolence, and P<0.0001 for hyperactivity/irritability).

Bedwetting, restless sleep, and excessive vocalizations were also reported more frequently for snorers than for non-snorers (P<0.01, P<0.01, and P<0.05, respectively).

These findings have triggered further research, Dr. Rodopman-Arman said. They will be comparing habitual snorers to non-snoring controls and use such instruments as Conner's Attention Deficit Hyperactivity Parent and Teacher Forms, as well as the Achenbach's Child Behaviour Checklist and Teacher Report Forms.

The study was funded by Fahrettin Kerim Gokay Foundation, Istanbul, Turkey.


[Study title: Behavioral Problems Associated With Snoring in a Wide Community Sample. Abstract A3]

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