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Possible negative effects of snoring and increased sleep fragmentation on developmental status of preschool children

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Abstract

Limited studies have investigated the effects of snoring although harmful neurocognitive effects of obstructive sleep apnea syndrome are relatively well known. The aim of the present study was to investigate the effects of snoring and fragmented sleep on mental development in preschool children. The study population consisted of 212 healthy preschool children (age range 3.1–6 years; mean = 5.4 ± 0.6 years; 112 boys, 100 girls). The developmental status of the children was investigated by using the Ankara Developmental Screening Inventory (ADSI) and Peabody Picture Vocabulary Test (PBT). Children’s sleep and snoring frequency were assessed by using parent completed Children’s Sleep Habits Questionnaire (CSHQ). Snoring children had lower scores of language/cognitive skills, social/activities of daily living skills, and general development compared to controls (P < 0.05). The snoring group had more males, and more fragmented sleep than controls (P < 0.05). No significant difference was found in sleep duration between the snoring children and controls (P > 0.05). Children with fragmented sleep had lower scores of language/cognitive skills, fine motor skills, social/activities of daily living skills, and general development compared to controls (P < 0.05). In addition, no significant correlation was found between sleep duration and the developmental test scores (P > 0.05). Present study suggested that healthy preschool children who have habitual snoring or sleep fragmentation may have reduced scores of various mental development compared to controls. Uninterrupted sleep may be more important than sleep duration for the development of the various mental abilities in healthy preschool children. More studies investigating snoring and sleep fragmentation on mental development in children are warranted for a definite conclusion.

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References

  1. Katz ES, D’Ambrosio CM. Pediatric obstructive sleep apnea syndrome. Clin. Chest Med. 2010; 31 (2): 221–34.

    Article  PubMed  Google Scholar 

  2. Ali NJ, Pitson D, Stradling JR. Sleep disordered breathing: effects of adenotonsillectomy on behaviour and psychological functioning. Eur. J. Pediatr. 1996; 155 (1): 56–62.

    Article  CAS  PubMed  Google Scholar 

  3. Guilleminault C, Winkle R, Korobkin R, Simmons B. Children and nocturnal snoring: evaluation of the effects of sleep related respiratory resistive load and daytime functioning. Eur. J. Pediatr. 1982; 139 (3): 165–71.

    Article  CAS  PubMed  Google Scholar 

  4. Owens J, Spirito A, Marcotte A, McGuinn M, Berkelhammer L. Neuropsychological and behavioral correlates of obstructive sleep apnea syndrome in children: a preliminary study. Sleep Breath. 2000; 4 (2): 67–78.

    Article  PubMed  Google Scholar 

  5. Blunden S, Lushington K, Kennedy D, Martin J, Dawson D. Behavior and neurocognitive performance in children aged 5–10 years who snore compared to controls. J. Clin. Exp. Neuropsychol. 2000; 22 (5): 554–68.

    Article  CAS  PubMed  Google Scholar 

  6. O’Brien LM, Mervis CB, Holbrook CR et al. Neurobehavioral correlates of sleep-disordered breathing in children. J. Sleep Res. 2004; 13 (2): 165–72.

    Article  PubMed  Google Scholar 

  7. Rhodes SK, Shimoda KC, Waid LR et al. Neurocognitive deficits in morbidly obese children with obstructive sleep apnea. J. Pediatr. 1995; 127 (5): 741–4.

    Article  CAS  PubMed  Google Scholar 

  8. Gozal D. Sleep-disordered breathing and school performance in children. Pediatrics 1998; 102 (3 Pt 1): 616–20.

    Article  CAS  PubMed  Google Scholar 

  9. Weissbluth M, Davis AT, Poncher J, Reiff J. Signs of airway obstruction during sleep and behavioral, developmental, and academic problems. J. Dev. Behav. Pediatr. 1983; 4 (2): 119–21.

    Article  CAS  PubMed  Google Scholar 

  10. Marcus CL. Sleep-disordered breathing in children. Am. J. Respir. Crit. Care Med. 2001; 164 (1): 16–30.

    Article  CAS  PubMed  Google Scholar 

  11. Lumeng JC, Chervin RD. Epidemiology of pediatric obstructive sleep apnea. Proc. Am. Thorac. Soc. 2008; 5 (2): 242–52.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Ng DK, Chow PY, Chan CH, Kwok KL, Cheung JM, Kong FY. An update on childhood snoring. Acta Paediatr. 2006; 95 (9): 1029–35.

    Article  PubMed  Google Scholar 

  13. O’Brien LM, Mervis CB, Holbrook CR et al. Neurobehavioral implications of habitual snoring in children. Pediatrics 2004; 114 (1): 44–9.

    Article  PubMed  Google Scholar 

  14. Aronen ET, Liukkonen K, Simola P et al. Mood is associated with snoring in preschool-aged children. J. Dev. Behav. Pediatr. 2009; 30 (2): 107–14.

    Article  PubMed  Google Scholar 

  15. Piteo AM, Kennedy JD, Roberts RM et al. Snoring and cognitive development in infancy. Sleep Med. 2011; 12 (10): 981–7.

    Article  CAS  PubMed  Google Scholar 

  16. Montgomery-Downs HE, Gozal D. Snore-associated sleep fragmentation in infancy: mental development effects and contribution of secondhand cigarette smoke exposure. Pediatrics 2006; 117 (3): e496–502.

    Article  PubMed  Google Scholar 

  17. Scher A. Infant sleep at 10 months of age as a window to cognitive development. Early Hum. Dev. 2005; 81 (3): 289–92.

    Article  PubMed  Google Scholar 

  18. Kennedy JD, Blunden S, Hirte C et al. Reduced neurocognition in children who snore. Pediatr. Pulmonol. 2004; 37 (4): 330–7.

    Article  CAS  PubMed  Google Scholar 

  19. Brockmann PE, Urschitz MS, Schlaud M, Poets CF. Primary snoring in school children: prevalence and neurocognitive impairments. Sleep Breath. 2012; 16 (1): 23–9.

    Article  PubMed  Google Scholar 

  20. Redline S, Tishler PV, Hans MG, Tosteson TD, Strohl KP, Spry K. Racial differences in sleep-disordered breathing in African-Americans and Caucasians. Am. J. Respir. Crit. Care Med. 1997; 155 (1): 186–92.

    Article  CAS  PubMed  Google Scholar 

  21. Urschitz MS, Guenther A, Eggebrecht E et al. Snoring, intermittent hypoxia and academic performance in primary school children. Am. J. Respir. Crit. Care Med. 2003; 168 (4): 464–8.

    Article  PubMed  Google Scholar 

  22. Agargun MY, Cilli AS, Sener S et al. The prevalence of parasomnias in preadolescent school-aged children: a Turkish sample. Sleep 2004; 27 (4): 701–5.

    PubMed  Google Scholar 

  23. Ng DK, Kwok KL, Cheung JM et al. Prevalence of sleep problems in Hong Kong primary school children: a community-based telephone survey. Chest 2005; 128 (3): 1315–23.

    Article  PubMed  Google Scholar 

  24. Sahin U, Ozturk O, Ozturk M, Songur N, Bircan A, Akkaya A. Habitual snoring in primary school children: prevalence and association with sleep-related disorders and school performance. Med. Princ. Pract. 2009; 18 (6): 458–65.

    Article  PubMed  Google Scholar 

  25. Ivanenko A, Gururaj BR. Classification and epidemiology of sleep disorders. Child Adolesc. Psychiatr. Clin. N. Am. 2009; 18: 839–48.

    Article  PubMed  Google Scholar 

  26. Goodlin-Jones BL, Sitnick SL, Tang K, Liu J, Anders TF. The Children’s Sleep Habits Questionnaire in toddlers and preschool children. J. Dev. Behav. Pediatr. 2008; 29 (2): 82–8.

    Article  PubMed  Google Scholar 

  27. Fiş NP, Arman A, Ay P et al. Çocuk Uyku Alışkanlıkları Anketinin Türkçe geçerliliği ve güvenilirliğ i [The validity and the reliability of Turkish Version of Children’s Sleep Habits Questionnaire]. Anatolian J. Psychiatry 2010; 11 (2): 151–60.

    Google Scholar 

  28. Savasir I, Sezgin N, Erol N. 0–6 Yas Cocuklari icin Gelisim Tarama Envanteri Gelistirilmesi: On Calismalar [Construction of a developmental screening inventory for 0–6 years-old children: pilot studies]. Turk Psikiyatri Derg. 1992; 3 (2): 33–8.

    Google Scholar 

  29. Savasir I, Sezgin N, Erol N. Ankara Gelisim Tarama Envanteri [Ankara Developmental Screening Inventory], 2nd edn. Turkish Psychological Association: Ankara, 19

  30. Dunn LM, Dunn LM. Peabody Picture Vocabulary Test, 3rd edn. American Guidance Service: Circle Pines, MN, 19

    Google Scholar 

  31. Oner N. Türkiye’de Kullanilan Psikolojik Testlerden Örnekler [Examples of Psychological Tests Used in Turkey], 2nd Expanded edn. Bogazici University Press: İstanbul, 20

    Google Scholar 

  32. Owens JA, Spirito A, McGuinn M. Sleep habits and sleep disturbance in elementary school-aged children. J. Dev. Behav. Pediatr. 2000; 21: 27–36.

    Article  CAS  PubMed  Google Scholar 

  33. Montgomery-Downs HE, Jones VF, Molfese VJ, Gozal D. Snoring in preschoolers: associations with sleepiness, ethnicity, and learning. Clin. Pediatr. (Phila) 2003; 42 (8): 719–26.

    Article  Google Scholar 

  34. Gottlieb DJ, Chase C, Vezina RM et al. Sleep-disordered breathing symptoms are associated with poorer cognitive function in 5-year-old children. J. Pediatr. 2004; 145 (4): 458–64.

    Article  PubMed  Google Scholar 

  35. Gozal D, Daniel JM, Dohanich GP. Behavioral and anatomical correlates of chronic episodic hypoxia during sleep in the rat. J. Neurosci. 2001; 21 (7): 2442–50.

    CAS  PubMed  Google Scholar 

  36. Payne RS, Goldbart A, Gozal D, Schurr A. Effect of intermittent hypoxia on long-term potentiation in rat hippocampal slices. Brain Res. 2004; 1029 (2): 195–9.

    Article  CAS  PubMed  Google Scholar 

  37. Kheirandish L, Gozal D. Neurocognitive dysfunction in children with sleep disorders. Dev. Sci. 2006; 9 (4): 388–99.

    Article  PubMed  Google Scholar 

  38. Guzman-Marin R, Bashir T, Suntsova N, Szymusiak R, McGinty D. Hippocampal neurogenesis is reduced by sleep fragmentation in the adult rat. Neuroscience 2007; 148 (1): 325–33.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Sportiche N, Suntsova N, Methippara M et al. Sustained sleep fragmentation results in delayed changes in hippocampal-dependent cognitive function associated with reduced dentate gyrus neurogenesis. Neuroscience 2010; 170 (1): 247–58.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Tartar JL, Ward CP, McKenna JT et al. Hippocampal synaptic plasticity and spatial learning are impaired in a rat model of sleep fragmentation. Eur. J. Neurosci. 2006; 23 (10): 2739–48.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Brunetti L, Rana S, Lospalluti ML et al. Prevalence of obstructive sleep apnea syndrome in a cohort of 1,207 children of southern Italy. Chest 2001; 120 (6): 1930–5.

    Article  CAS  PubMed  Google Scholar 

  42. Kaditis AG, Finder J, Alexopoulos EI et al. Sleepdisordered breathing in 3,680 Greek children. Pediatr. Pulmonol. 2004; 37 (6): 499–509.

    Article  PubMed  Google Scholar 

  43. Mitchell EA, Thompson JM. Snoring in the first year of life. Acta Paediatr. 2003; 92 (4): 425–9.

    Article  CAS  PubMed  Google Scholar 

  44. Castronovo V, Zucconi M, Nosetti L et al. Prevalence of habitual snoring and sleep-disordered breathing in preschool-aged children in an Italian community. J. Pediatr. 2003; 142 (4): 377–82.

    Article  PubMed  Google Scholar 

  45. Montgomery-Downs HE, Gozal D. Sleep habits and risk factors for sleep-disordered breathing in infants and young toddlers in Louisville, Kentucky. Sleep Med. 2006; 7 (3): 211–9.

    Article  PubMed  Google Scholar 

  46. Rosen CL, Larkin EK, Kirchner HL et al. Prevalence and risk factors for sleep-disordered breathing in 8-to 11-year-old children: association with race and prematurity. J. Pediatr. 2003; 142 (4): 383–9.

    Article  PubMed  Google Scholar 

  47. Bonnet MH, Arand DL. Clinical effects of sleep fragmentation versus sleep deprivation. Sleep Med. Rev. 2003; 7 (4): 297–310.

    Article  PubMed  Google Scholar 

  48. Tikotzky L, Sadeh A. Sleep patterns and sleep disruptions in kindergarten children. J. Clin. Child Psychol. 2001; 30 (4): 581–91.

    Article  CAS  PubMed  Google Scholar 

  49. Weinraub M, Bender RH, Friedman SL et al. Patterns of developmental change in infants’ nighttime sleep awakenings from 6 through 36 months of age. Dev. Psychol. 2012; 48 (6): 1511–28.

    Article  PubMed  Google Scholar 

  50. Tremaine R, Dorrian J, Blunden S. Subjective and objective sleep in children and adolescents: measurement, age, and gender differences. Sleep Biol. Rhythms 2010; 8 (4): 229–38.

    Article  Google Scholar 

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Yorbik, O., Mutlu, C., Koc, D. et al. Possible negative effects of snoring and increased sleep fragmentation on developmental status of preschool children. Sleep Biol. Rhythms 12, 30–36 (2014). https://doi.org/10.1111/sbr.12042

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