A large study of children has uncovered evidence that behavioural problems in children who snore may be associated with changes in the structure of their brain's frontal lobe. The findings support the early evaluation of children with habitual snoring.

The research, published in Nature Communications, was supported by the National Institute on Drug Abuse (NIDA) and nine other Institutes, Centers, and Offices of the National Institutes of Health. Large, population-based studies have established a clear link between snoring and behavioural problems, such as inattention or hyperactivity, but the exact nature of this relationship is not fully understood.

While a few small studies have reported a correlation between sleep apnea when pauses in breathing are prolonged and certain brain changes, little is known about whether these changes contribute to the behaviours seen in some children with obstructive sleep-disordered breathing (oSDB), a group of conditions commonly associated with snoring that is characterized by resistance to breathing during sleep.

To address this knowledge gap, researchers led by Amal Isaiah, M.D., D.Phil., of the University of Maryland School of Medicine, capitalised on the large and diverse dataset provided by the Adolescent Brain Cognitive Development (ABCD) Study, a long-term study of child health and brain development in the United States. The team of researchers mined this wealth of data from more than 11,000 9- and 10-year-old children to examine the relationships among snoring, brain structure, and behavioural problems.

Confirming the results of previous work, their statistical analysis revealed a positive correlation between habitual snoring and behavioural problems, with the children who most frequently snored generally exhibiting worse behaviour according to an assessment completed by parents. The findings further showed that snoring is linked to smaller volumes of multiple regions of the brain's frontal lobe, an area involved in cognitive functions such as problem-solving, impulse control, and social interactions.

The statistical analysis also suggested that the brain differences seen in children who snore may contribute to behavioural problems, but additional work on how snoring, brain structure, and behavioural problems change over time is needed to confirm a causal link. This study's findings point to oSDB as a potentially reversible cause of behavioural problems, suggesting that children routinely be screened for snoring. Children who habitually snore may then be referred for follow-up care. Such care may include assessment and treatment for conditions that contribute to oSDB, such as obesity, or evaluation for surgical removal of the adenoids and tonsils.

The ABCD Study, the largest of its kind in the United States, is tracking nearly 12,000 youth as they grow into young adults. Investigators regularly measure participants' brain structure and activity using magnetic resonance imaging (MRI) machines and collect psychological, environmental, and cognitive information, as well as biological samples. The goal of the study is to define standards for normal brain and cognitive development and to identify factors that can enhance or disrupt a young person's life trajectory.

The Adolescent Brain Cognitive Development Study and ABCD Study are service marks and registered trademarks, respectively, of the US Department of Health and Human Services.