Snoring Linked to Structural Brain Changes and ADHD-like Behaviors in Kids

By Megan Brooks

April 19, 2021

NEW YORK (Reuters Health) - Behavioral problems in children who regularly snore may be associated with structural changes in the brain, new research suggests.

Studies have shown a clear link between childhood snoring, a sign of obstructive sleep disordered breathing (oSDB), and behavioral problems, such as inattention or hyperactivity, hallmarks of attention-deficit hyperactivity disorder (ADHD), but the exact nature of this relationship remains unclear.

A team of researchers led by Dr. Amal Isaiah of the University of Maryland School of Medicine, in Baltimore, assessed associations between oSDB symptoms, behavioral issues such as inattention, and brain structure in more than 10,000 preadolescents (ages 9 to 10 years) from the Adolescent Brain Cognitive Development (ABCD) study.

Confirming prior work, they found a positive correlation between habitual snoring and behavioral problems, with the children who snored the most generally having worse parent-reported behavior.

Habitual snoring was also linked to thinner cortical gray matter within several regions of the frontal lobe, which is involved in cognitive functions such as problem solving, impulse control and social interactions.

"Importantly, the magnitude of the relationship between the oSDB symptoms and behavioral measures was mediated by regional cortical volumes," the researchers note in their Nature Communications paper.

The findings point to oSDB as a potentially reversible cause of behavioral problems, they say.

"This is the largest study of its kind detailing the association between snoring and brain abnormalities," Dr. Isaiah said in a news release. "These brain changes are similar to what you would see in children with attention deficit hyperactivity disorder. Children have a loss of cognitive control, which is additionally associated with disruptive behavior."

In an email to Reuters Health, Dr. Isaiah noted that while children with ADHD are much more likely to snore than peers without ADHD, to his knowledge, "there are no firm guidelines on screening for snoring in children with symptoms of ADHD or other behavioral disorders. These findings may provide justification to do so."

Dr. Isaiah also said several key questions remain, including the mechanism of brain changes related to snoring.

"As snoring may be associated with sleep disruption and/or reduced oxygen supply to the brain, identifying this mechanism will illuminate better treatment," he said. It's also unclear whether the brain alterations are reversible with treatment.

The study had no commercial funding. Dr. Isaiah has patents (pending or granted) related to the diagnosis and treatment of sleep apnea in adults using ultrasound.

SOURCE: https://go.nature.com/3wVL2Qh Nature Communications, online April 13, 2021.

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