Habitual snoring associated with brain changes in children

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Sleep Health | Sleep Review

Children who snore regularly have structural changes in their brain that may be responsible for the behavioral problems associated with the condition, including lack of concentration, hyperactivity, and learning difficulties at school. That’s the result of a new study by researchers at the University of Maryland School of Medicine (UMSOM) published in the journal Nature Communications.

To conduct the study, researchers examined MRI images from more than 10,000 children, ages 9-10, who participated in the Adolescent Brain Cognitive Development (ABCD) study, the largest long-term study of brain development and child health in the United States. UMSOM researchers are co-researchers in this ongoing study.

They found that children who snored regularly (three times a week), as reported by their parents, were more likely to have thinner gray matter in multiple regions in the frontal lobes of their brain. These areas of the brain are responsible for higher thinking skills and impulse control. The thinner cortex in these regions has been correlated with behavioral disorders associated with a sleep-related breathing disorder, a severe form of which is known as sleep apnea. These behavioral problems include lack of focus, learning difficulties, and impulsive behavior. Snoring causes sleep disorders throughout the night due to interrupted breathing and decreased oxygen supply to the brain.

“This is the largest study of its kind detailing the link between snoring and brain abnormalities,” says the study’s lead author, Amal Isaiah, MD, PhD, Associate Professor of Otorhinolaryngology – Head and Neck Surgery and Pediatrics at UMSOM, in a press release. “These changes in the brain are similar to what you would see in children with attention deficit hyperactivity disorder. Children have a loss of cognitive control, which is also associated with disruptive behavior. “

Isaiah advised parents: “If you have a child who snores more than twice a week, that child needs evaluation. We now have strong structural evidence from brain imaging to underline the importance of diagnosing and treating sleep-disordered breathing in children. “

The condition can be treated with tonsillectomy and adenoidectomy, which are considered the first line of treatment for children with symptoms of snoring, breathing pauses during sleep, and mouth breathing.

“We know that the brain has the ability to repair itself, especially in children, so early detection and treatment of obstructive sleep disorders through breathing can mitigate these changes in the brain. More research is needed to validate such mechanisms for these relationships, which can also lead to further treatment approaches, ”says Linda Chang, MD, MS, co-author of the study, professor of diagnostic radiology and nuclear medicine who is a co-research director at ABCD is study in a publication.

The researchers plan to conduct a follow-up study to see if children who continue to snore have seen brain findings deteriorating on MRIs.

“For the first time, we are seeing evidence in brain imaging that measures the toll this common disorder can have on a child’s neurological development,” said E. Albert Reece, MD, PhD, MBA, executive vice president for medical affairs , UM Baltimore. and the John Z. and Akiko K. Bowers Distinguished Professor and Dean, University of Maryland School of Medicine, in a press release. “This is an important finding that underscores the need to properly diagnose abnormal snoring in children.”

The research was supported by the National Institute on Drug Abuse (NIDA) and nine other institutes, centers, and offices of the National Institutes of Health.

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