Curing A Kid's Snore May Bring Behavior Benefits

Electrodes being placed on 5-year-old Fletcher Hedley i i

Five-year-old Fletcher Hedley prepares for a sleep test at Hasbro Children's Hospital in Providence, R.I. John Hedley hide caption

itoggle caption John Hedley
Electrodes being placed on 5-year-old Fletcher Hedley

Five-year-old Fletcher Hedley prepares for a sleep test at Hasbro Children's Hospital in Providence, R.I.

John Hedley

Web Chat

Web Chat: Why We Snore And How To Stop It

  

You know who you are. Or maybe you sleep next to one. About 20 percent of adults snore. But it gets worse — by age 60, nearly half of all adults snore. The good news is that there are lots of ways to silence that roar.

  

Drs. Sonya Malekzadeh and Judith Owens answer your questions in a Web chat.

Sherry and Michael Wasylyk i i

Sherry and Michael Wasylyk say his sleep has greatly improved since his tonsillectomy. Sherry Wasylyk hide caption

itoggle caption Sherry Wasylyk
Sherry and Michael Wasylyk

Sherry and Michael Wasylyk say his sleep has greatly improved since his tonsillectomy.

Sherry Wasylyk

A snoring child may sound like a purring kitten, but researchers say that if the snoring is chronic, it could be a sign of an underlying sleep disorder that can have wide-ranging effects on learning and behavior.

"Any child that presents with mood issues, irritability, impulsivity, aggressive behavior... attention problems or with academic issues, you have to think about their sleep," says Dr. Judith Owens, who directs the Pediatric Sleep Disorders Clinic at Hasbro Children's Hospital in Providence, R.I.

Dr. Michael Schechter, a pediatric pulmonologist and epidemiologist at Emory University in Atlanta, agrees, and says the problem is fairly common. About 12 percent of children under the age of 10 are habitual snorers. The sound can signal a sleep problem that is sometimes neurological or caused by a blockage in airways that leads to sleep apnea. That's an interruption in breathing that triggers mini-awakenings throughout the night to catch a breath. In other cases, the noise of the snoring alone is enough to disrupt sleep.

Symptoms Like ADHD

But whatever the cause, Schechter says, a recent study suggests that these "habitual snorers" are two to three times more likely than non-snorers to suffer the kinds of behavior and learning problems more typically associated with attention deficit and hyperactivity disorder.

"It can look a lot like ADHD," Schechter says.

That was the case with 12-year-old Michael Wasylyk, one of Owens' patients in Providence. Michael's mom, Sherry, says his teachers suggested his lack of focus in school and inattention might be ADHD and even implied, she thought, that medication was in order. But Sherry Wasylyk had been noticing other symptoms, including snoring.

"Last spring, Michael was increasingly moody," she says. "He was not doing well in school and would be so tired." She checked with her pediatrician, who sent Michael for an overnight monitoring session at the sleep clinic.

  

Owens discovered that Michael had mild "obstructive sleep apnea"; his oxygen levels were dipping at night as he struggled for breath. Enlarged tonsils, Owens says, were narrowing his airway; he's also a little heavy for his age, and any extra weight in the neck can aggravate the problem.

  

Tonsillectomy Did The Trick

  

Last fall, Michael had his tonsils removed. Sherry Wasylyk says not only has that helped with the snoring, but his mood, confidence and school performance have all also dramatically improved.

  

"He remarked after the operation for the tonsillectomy, 'Mom, I don't believe how different I feel ... I really feel good. I never used to feel good when I woke up in the morning,' " she recalls.

  

Owens says she's not surprised. A recent study from the team of pediatric sleep expert Dr. David Gozal, who is now at the University of Chicago, demonstrated a strong link between better sleep and improved academics.

  

"They looked at kids that were in the bottom 10th percentile of class. And first of all, they determined those kids were more likely to snore and have symptoms of sleep apnea than children in the top percentile," Owens says. "But, furthermore, when they treated the sleep apnea, their percentile significantly improved."

  

Removal of the tonsils and adenoids isn't the right treatment for everyone, she says. Some children who snore because of allergies or asthma can better benefit from medication for those conditions. And those whose sleep problem is related to obesity will improve when they lose pounds; in those cases a good diet and exercise regimen is called for.

  

Spotting Young Snorers

  

The key is to catch the sleep problem as early as possible, sleep experts agree. " It may be that having sleep apnea at age 4 or 5, even if it's mild, may be more important than having it when you're 25." Owens says.

  

When Providence boat restorer, John Hedley, and his wife noticed that their 4-year-old son was suddenly dissolving in daily temper tantrums — and snoring like a panting puppy at night — their pediatrician referred them to Owens and the sleep clinic.

  

"Fletcher was having periodic breathing pauses throughout the course of the night," says Owens, who diagnosed the child with mild sleep apnea. "He also had some dips in oxygen levels and, as you can imagine, a developing brain really needs oxygen." Based on his medical history, Owens thinks, removing Fletcher's adenoids and tonsils should solve both his sleeping and behavioral problems.

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