Primary snoring in school children: prevalence and neurocognitive impairments

Area of Science:

• Pediatric Sleep Medicine
• Neurodevelopmental Pediatrics
• Community Health Research

Background:

• Primary snoring (PS) is common in children, but its impact on neurocognitive function is not fully understood.
• Distinguishing PS from more severe sleep-disordered breathing like obstructive sleep apnea (OSA) is crucial for appropriate management.
• Previous research has primarily focused on OSA, leaving the effects of non-apneic snoring under-examined.

Purpose of the Study:

• To determine the prevalence of primary snoring (PS) in a pediatric population.
• To investigate the association between PS and neurocognitive impairments in school-aged children.
• To compare the neurocognitive outcomes of children with PS to those with upper airway resistance syndrome (UARS) or OSA and non-snorers.

Main Methods:

• A community-based study involving 1,114 primary school children.
• Identification of children who never snored (N=410) and habitually snored (N=114).
• Home polysomnography performed on habitual snorers to differentiate PS from UARS/OSA, followed by neurocognitive assessments and school performance analysis.

Main Results:

• The prevalence of PS was 6.1% (95% CI: 4.5-7.7).
• Children with PS showed significantly higher rates of hyperactivity (39% vs. 20%) and inattention (33% vs. 11%) compared to non-snorers.
• PS was a significant risk factor for hyperactivity, inattention, daytime sleepiness, and poor academic performance in mathematics, science, and spelling, with similar odds ratios to the UARS/OSA group.

Conclusions:

• Non-hypoxic, non-apneic primary snoring in children is associated with notable neurocognitive deficits.
• The negative consequences of PS on neurocognition and school performance appear comparable to those seen in UARS or OSA.
• Primary snoring should not be considered benign and warrants consideration for treatment to mitigate potential long-term impacts.