Sleep and Behavioral Problems Linked

From the WebMD Archives

March 4, 2002 -- Researchers aren't sure which causes which, or how, or why, but they've established a fairly strong link between sleep problems and behavioral problems in children, especially young boys.

The study, published in the March issue of the journal Pediatrics, is the largest to look into the possible connection between inattention/hyperactivity and sleep.

Ronald D. Chervin, MD, MS, with University of Michigan Medical School, and colleagues surveyed parents of more than 850 boys and girls, aged 2-14, in pediatric waiting rooms.

The researchers asked the parents whether their children exhibited symptoms of attention deficit hyperactivity disorder (ADHD), such as inattention to tasks and schoolwork, distraction, forgetfulness, fidgeting, and excessive talking. They also asked whether the children snored, were often sleepy, or exhibited other symptoms indicative of sleep problems, such as difficulty waking up in the morning or mouth-breathing during the day.

The researchers tallied scores for each symptom or behavior on a sliding scale. Overall, 16% of the kids were frequent snorers and 13% scored high for hyperactivity. Interestingly, 22% of the habitual snorers were hyperactive, compared with only 12% of the infrequent snorers or nonsnorers. The same pattern held when they looked at the relationship from the opposite direction.

Next, they stratified the children by age and sex and found that the snoring link was most dramatic in boys under 8 years old. In this group, 30% of regular snorers had high hyperactivity scores, compared with only 9% of less frequent snorers.

"If there is indeed a cause-and-effect link, sleep problems in children could represent a major public health issue," says Chervin in a news release. "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."

Although more research is needed, these findings do suggest that parents should be keeping an eye out for snoring, daytime sleepiness, and other symptoms that could point to nighttime breathing difficulties. Fortunately, he says, sleep breathing problems, poor sleep habits, and other causes of daytime sleepiness can be fixed.