Breathing difficulty during sleep or sleep apnea, can raise risk of behavioural as well as adaptive and learning problems in children, a new study has found. US researchers found that obstructive sleep apnea, a common form of sleep-disordered breathing (SDB), is associated with increased rates of Attention deficit-hyperactivity disorder (ADHD) like behavioural problems in children. "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 behavioural risks associated with continued SDB," said Michelle Perfect, the study's lead author from the University of Arizona in Tucson. "School personnel should also consider the possibility that SDB contributes to difficulties with hyperactivity, learning and behavioural and emotional dysregulation in the classroom," Perfect said. The five-year study, published in the journal SLEEP, utilised data from a longitudinal cohort, the Tucson Children's Assessment of Sleep Apnea Study (TuCASA). The TuCASA study prospectively examined Hispanic and Caucasian children between 6 and 11 years of age to determine the prevalence and incidence of SDB and its effects on neurobehavioural functioning. The study involved 263 children who completed an overnight sleep study and a neurobehavioural battery of assessments that included parent and youth reported rating scales. Results showed that 23 children had incident sleep apnea that developed during the study period, and 21 children had persistent sleep apnea throughout the entire study.
Another 41 children who initially had sleep apnea no longer had breathing problems during sleep at the five-year follow-up. The odds of having behavioural problems were four to five times higher in children with incident sleep apnea and six times higher in children who had persistent sleep apnea. Compared to youth who never had SDB, children with sleep apnea were more likely to have parent-reported problems in the areas of hyperactivity, attention, disruptive behaviours, communication, social competency and self-care, according to an American Academy of Sleep Medicine statement. Children with persistent sleep apnea also were seven times more likely to have parent-reported learning problems and three times more likely to have school grades of C or lower. "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," said Perfect.