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Natural history of snoring and related behaviour problems between the ages of 4 and 7 years
N J Ali1, D Pitson, J R Stradling
1Osler Chest Unit, Churchill Hospital, Headington, Oxford.
Insights
Habitual snoring in young children often resolves within two years, but new cases emerge, maintaining overall prevalence. Daytime sleepiness, hyperactivity, and restless sleep are linked to habitual snoring.
Area of Science:
- Pediatric Sleep Medicine
- Child Behavior Studies
Background:
- Snoring is common in children and may be associated with behavioral issues.
- Longitudinal data on the natural history of childhood snoring and related symptoms are limited.
Purpose of the Study:
- To investigate the natural history of habitual snoring and associated symptoms in preschool children.
- To examine the relationship between snoring and behavioral problems over a two-year period.
Main Methods:
- A cohort of 782 children aged 4-5 years was surveyed for snoring and related symptoms.
- Two years later, the same cohort was re-evaluated using questionnaires.
- Response rates were 64.8%, with non-respondents showing similar prevalence rates.
Main Results:
- The prevalence of habitual snoring remained stable (12.1% to 11.4%), with over 50% of initial habitual snorers no longer snoring.
- Hyperactivity and restless sleep prevalence showed little change, while daytime sleepiness significantly decreased (20.7% to 10.2%).
- Habitual snoring was significantly associated with increased risks of daytime sleepiness (RR 6.13), hyperactivity (RR 2.78), and restless sleep (RR 2.3).
Conclusions:
- Childhood habitual snoring and associated behavioral problems can resolve spontaneously in about half of cases.
- Despite spontaneous resolution, new cases emerge, leading to a stable overall prevalence of these conditions.
- Daytime sleepiness, hyperactivity, and restless sleep are significantly more prevalent in habitual snorers, highlighting the importance of addressing snoring in children.
Abstract:
In 1989-90 a survey was carried out of the prevalence of snoring and related symptoms in 782 4 to 5 year old children. Two years later, in 1992, the same group of children was studied to gather information on the natural history of snoring and the related behaviour problems. A total of 507/782 (64.8%) completed questionnaires were received. Comparison of the responses with the 1989-90 survey showed that those who did not reply to the questionnaire were no different from the respondents in terms of the prevalence of snoring, daytime sleepiness, hyperactivity, and restless sleep. The overall prevalence of habitual snoring did not change between the two surveys (12.1% in 1989-90 v 11.4% in 1992), though more than half of the children who snored habitually in the original survey no longer did so. There was little change in the prevalence of hyperactivity (24.2% in 1989-90 v 20.7% in 1992) or restless sleep (both 39%) among the 507 who responded to the present survey. The prevalence of daytime sleepiness, however, did decrease substantially (20.7% in 1989-90 v 10.2% in 1992). There was moderate agreement between the individual questionnaire responses for the 1989-90 and 1992 surveys for snoring (weighted kappa 0.52), but poor agreement for the other symptoms (daytime sleepiness 0.37, hyperactivity 0.35, and restless sleep 0.38). Trend analysis showed that the increasing prevalence of sleepiness, hyperactivity, and restless sleep across the snoring categories was highly significant. Daytime sleepiness, hyperactivity, and restless sleep were all significantly more common in the habitual snorers than in those who never snored. Relative risks (95% confidence interval) were as follows: daytime sleepiness 6.13 (2.5 to 14.9), hyperactivity 2.78 (1.6 to 4.7), and restless sleep 2.3 (1.6 to 3.2). Though habitual snoring and the associated behaviour problems resolved spontaneously over two years in about half of the children with these symptoms, there is still the same overall percentage with these problems due to the emergence of new cases.