Link Found Between Kids’ Sleep, Behavior Problems; Parent Survey Connects Snoring And Sleepiness With Attention And Hyperactivity Issues

The link is strongest in boys under 8 years of age; habitual snorers in this group were more than three times more likely than non-snorers to be hyperactive. The study, based on a survey of the parents of 866 children that was conducted in the waiting rooms of U-M pediatrics clinics, is among the largest ever to explore the connection between sleep and inattention/hyperactivity.

While the study does not provide any clues as to whether and how sleep problems might contribute to behavior issues, or vice versa, the evidence of a link between the two is strong enough to warrant further and thorough investigation, says lead author Ronald Chervin, M.D., M.S., director of the Michael S. Aldrich Sleep Disorders Laboratory and associate professor of neurology at the U-M Medical School.

“If there is indeed a cause-and-effect link, sleep problems in children could represent a major public health issue,” says Chervin. “It’s conceivable that by better identifying and treating children’s snoring and other nighttime breathing problems, we could help address some of the most common and challenging childhood behavioral issues. But more research will be necessary to show whether this is the case.”

Until then, he suggests, all parents should pay attention to their children’s sleep behaviors — and their own. Sleep problems in both children and adults are under-diagnosed, even though they can have a major impact on daytime activity and health. Better sleep habits, and medical attention for issues such as snoring, daytime sleepiness, and breathing interruptions known as apnea, could help people of all ages function better during the day.

Chervin and his colleagues from UMHS, the University of Pittsburgh and Stanford University designed the study to gather as much information as possible on a large number of children, to overcome the limitations of previous studies that only looked at small groups of children who had been referred to sleep specialists.

They combined three different validated survey instruments: two asking parents about their children’s behavior patterns, and one asking about snoring, sleepiness and characteristics that may indicate sleep-disordered breathing problems. The children were all over the age of 2 and under the age of 14, and parents were asked to seek their children’s help in completing the survey. Fifty-four percent of the children assessed were boys.

The sleep portion of the survey asked about frequency and severity of snoring, as well as the tendency to struggle to breathe or stop breathing temporarily during the night, to breathe through the mouth during the day, to wake up feeling unrefreshed, or to have a hard time waking up. All these can mean a child has sleep-disordered breathing, which can affect the quality of their sleep.

Scores for snoring frequency and severity, and for sleepiness and sleep-disordered breathing, were tallied for each child, to allow each tendency to be considered on its own. And, children w