Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Breathing problems during sleep may affect mental development in infants and young children

07.10.2004


Children who have problems breathing during sleep tend to score lower on tests of mental development and intelligence than do other children their age, according to two studies funded by the National Institutes of Health (NIH). Both studies appear in the October issue of Journal of Pediatrics.



The first study, funded by the National Institute of Child Health and Human Development (NICHD), found that at one year of age, infants who have multiple, brief breathing pauses (apnea) or slow heart rates during sleep scored lower on mental development tests than did other infants of the same age. The second study was funded primarily by the National Heart, Lung, and Blood Institute (NHLBI). Results show that 5-year-old children who had frequent snoring, loud or noisy breathing during sleep, or sleep apneas observed by parents scored lower on intelligence, memory, and other standard cognitive tests than other children their age. They were also more likely to have behavioral problems.

"The findings from these studies support other research that has shown that breathing problems during sleep are associated with serious health consequences in children," said Carl E. Hunt, M.D., director of the NIH National Center on Sleep Disorders Research (NCSDR). "However, at this point we don’t know if the sleep problems during these episodes cause the decline in test scores or if the sleep episodes and the lower test scores are both related to some common underlying mechanism."


More than 10 percent of young children have habitual snoring, the mildest form of sleep-disordered breathing (SDB). One to three percent of children have obstructive sleep apnea, a more severe form of SDB in which breathing stops briefly and repeatedly during sleep. SDB is thought to be more common in toddlers and younger children than in older children because the younger ones are more likely to have large tonsils and adenoids, which can briefly block the airways in the back of the throat during sleep. African American children are twice as likely to develop SDB compared to white children. Children who are overweight or obese are also more likely to develop SDB.

In the first study, researchers evaluated 256 full-term and preterm infants at one year of age with a standardized test that measured physical and mental development. The infants were part of the multi-center Collaborative Home Infant Monitoring Evaluation (CHIME) study. The CHIME study sought to identify factors that could put infants at risk for sudden infant death syndrome (SIDS). Participants included healthy infants as well as those at increased risk of SIDS because they had a history of prematurity, a life-threatening event during sleep, or a sibling who had died from SIDS. The infants’ breathing, heart rates, and blood oxygen levels were monitored electronically at home for the first 4-6 months of age.

The researchers found that infants who totaled more than five episodes of abnormally slowed heart rate or apnea during the period they were monitored scored lower on the mental development test at one year of age than did infants who experienced fewer or no such episodes. The episodes were often associated with drops in oxygen levels. The lower mental development scores persisted even after data were adjusted to correct for other factors known to affect mental development in preterm infants. The study also found that full-term infants who experienced the abnormal episodes scored lower on the tests than did other full term infants, according to Hunt, the lead author, who conducted the research while at the Medical College of Ohio in Toledo.

The second study involved 205 children at 5 years of age. Researchers at Boston University School of Medicine compared neurocognitive function and behavior of 61 children with SDB symptoms to 144 children without symptoms. Symptoms of SDB, as reported by parents, included frequent snoring; heavy, loud, or noisy breathing during sleep; or observed apneas during sleep. An overnight sleep test (polysomnogram) was also performed to objectively measure the severity of SDB.

The study found that children with SDB symptoms scored lower on standard tests measuring executive function (attention and planning), memory, and general intelligence. These children also had significantly more behavioral problems than children without SDB symptoms, based on parental survey scores.

"One of the more remarkable findings in this study was that the neurocognitive effects were significant even among the children who had mild symptoms of sleep-disordered breathing but no actual sleep apneas," said Daniel Gottlieb, M.D., M.P.H., lead author of the study. "Parents need to be aware that their child’s snoring could signal serious problems."

The mild SDB symptoms associated primarily with snoring in these children result in frequent arousals and fragmented sleep, leading to poor sleep quality and hence to sleep deprivation. Today’s findings are similar to other studies of children and adults that link poor sleep or sleep deprivation to problems with school (or job) performance, difficulties with memory and concentration, increased risk of injuries, and trouble controlling impulses, emotions, and behavior, especially in children.

"Unfortunately, the effects of poor sleep are often overlooked or misinterpreted in children. Rather than appearing sleepy like adults who are sleep deprived, children may in fact seem to be more active or even hyperactive," comments Hunt.

In an accompanying editorial, Hunt notes that brain development is not complete until at least late childhood, and hence children may be uniquely vulnerable to SDB symptoms and their consequences, especially if such symptoms begin during infancy or early childhood. Brain areas, such as the prefrontal cortex, which regulate executive function, might be particularly susceptible to damage from SDB, writes Hunt.

In addition, other researchers have reported that the effects of SDB appear to have long-term consequences for children. For example, a University of Louisville study found that young children who snored loudly and frequently were more likely to have lower grades in middle school - even several years after the breathing problem was treated or resolved.

"These two new studies point to the need for parents and pediatricians to be on the watch for what might appear to be less serious breathing problems in their babies and young children when they sleep," notes Hunt. "If we can identify these children before the effects on mental development have occurred, the challenge then will be to identify possible ways to intervene and prevent any reduced potential for doing their best in school."

Scientists have not yet determined safe and effective ways to reduce cardiorespiratory episodes in infants. In children, however, treatment for SDB typically involves having the tonsils and adenoids surgically removed. In more severe cases, or for children who cannot have surgery, a machine known as continuous positive airway pressure (CPAP), which forces air into the air passages while the patient is sleeping, can be as effective in children as it is in adults with sleep apnea.

The health consequences associated with SDB in children are gaining increasing recognition. In April 2002, the American Academy of Pediatrics established clinical practice guidelines on obstructive sleep apnea in children. The guidelines call for all children to be screened for snoring and for children diagnosed with obstructive sleep apnea to be treated.

| EurekAlert!
Further information:
http://www.nhlbi.nih.gov/sleep.
http://www.nhlbi.nih.gov

More articles from Health and Medicine:

nachricht Using fragment-based approaches to discover new antibiotics
21.06.2018 | SLAS (Society for Laboratory Automation and Screening)

nachricht Scientists learn more about how gene linked to autism affects brain
19.06.2018 | Cincinnati Children's Hospital Medical Center

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Temperature-controlled fiber-optic light source with liquid core

In a recent publication in the renowned journal Optica, scientists of Leibniz-Institute of Photonic Technology (Leibniz IPHT) in Jena showed that they can accurately control the optical properties of liquid-core fiber lasers and therefore their spectral band width by temperature and pressure tuning.

Already last year, the researchers provided experimental proof of a new dynamic of hybrid solitons– temporally and spectrally stationary light waves resulting...

Im Focus: Overdosing on Calcium

Nano crystals impact stem cell fate during bone formation

Scientists from the University of Freiburg and the University of Basel identified a master regulator for bone regeneration. Prasad Shastri, Professor of...

Im Focus: AchemAsia 2019 will take place in Shanghai

Moving into its fourth decade, AchemAsia is setting out for new horizons: The International Expo and Innovation Forum for Sustainable Chemical Production will take place from 21-23 May 2019 in Shanghai, China. With an updated event profile, the eleventh edition focusses on topics that are especially relevant for the Chinese process industry, putting a strong emphasis on sustainability and innovation.

Founded in 1989 as a spin-off of ACHEMA to cater to the needs of China’s then developing industry, AchemAsia has since grown into a platform where the latest...

Im Focus: First real-time test of Li-Fi utilization for the industrial Internet of Things

The BMBF-funded OWICELLS project was successfully completed with a final presentation at the BMW plant in Munich. The presentation demonstrated a Li-Fi communication with a mobile robot, while the robot carried out usual production processes (welding, moving and testing parts) in a 5x5m² production cell. The robust, optical wireless transmission is based on spatial diversity; in other words, data is sent and received simultaneously by several LEDs and several photodiodes. The system can transmit data at more than 100 Mbit/s and five milliseconds latency.

Modern production technologies in the automobile industry must become more flexible in order to fulfil individual customer requirements.

Im Focus: Sharp images with flexible fibers

An international team of scientists has discovered a new way to transfer image information through multimodal fibers with almost no distortion - even if the fiber is bent. The results of the study, to which scientist from the Leibniz-Institute of Photonic Technology Jena (Leibniz IPHT) contributed, were published on 6thJune in the highly-cited journal Physical Review Letters.

Endoscopes allow doctors to see into a patient’s body like through a keyhole. Typically, the images are transmitted via a bundle of several hundreds of optical...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Munich conference on asteroid detection, tracking and defense

13.06.2018 | Event News

2nd International Baltic Earth Conference in Denmark: “The Baltic Sea region in Transition”

08.06.2018 | Event News

ISEKI_Food 2018: Conference with Holistic View of Food Production

05.06.2018 | Event News

 
Latest News

Graphene assembled film shows higher thermal conductivity than graphite film

22.06.2018 | Materials Sciences

Fast rising bedrock below West Antarctica reveals an extremely fluid Earth mantle

22.06.2018 | Earth Sciences

Zebrafish's near 360 degree UV-vision knocks stripes off Google Street View

22.06.2018 | Life Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>