Abstract
Parents frequently report behavioral problems among children who snore. Our understanding of the relationship between symptoms of obstructive sleep disordered breathing (oSDB) and childhood behavioral problems associated with brain structural alterations is limited. Here, we examine the associations between oSDB symptoms, behavioral measures such as inattention, and brain morphometry in the Adolescent Brain Cognitive Development (ABCD) study comprising 10,140 preadolescents. We observe that parent-reported symptoms of oSDB are associated with composite and domain-specific problem behaviors measured by parent responses to the Child Behavior Checklist. Alterations of brain structure demonstrating the strongest negative associations with oSDB symptoms are within the frontal lobe. The relationships between oSDB symptoms and behavioral measures are mediated by significantly smaller volumes of multiple frontal lobe regions. These results provide population-level evidence for an association between regional structural alterations in cortical gray matter and problem behaviors reported in children with oSDB.
Highlights
Parents frequently report behavioral problems among children who snore
Given the widely described relationship between obstructive sleep disordered breathing (oSDB) and behavioral measures, parent-reported symptoms of upper airway obstruction are central to screening for conditions such as obstructive sleep apnea[3], as well as the surgical decision making in hundreds of thousands of children undergoing tonsillectomy and adenoidectomy each year[11]
The frequency of snoring replicated this specific regional mediation effect (Supplementary Fig. 4, % mediated, 4.58 [1.67–11.44], P < 0.001). In this national study of brain development in typically developing children aged 9–10 years, greater symptom burden of oSDB as reported by the parent was associated with higher scores measured by child behavior checklist (CBCL) and thinner cortical gray matter within several frontal lobe regions
Summary
Parents frequently report behavioral problems among children who snore. Our understanding of the relationship between symptoms of obstructive sleep disordered breathing (oSDB) and childhood behavioral problems associated with brain structural alterations is limited. The relationships between oSDB symptoms and behavioral measures are mediated by significantly smaller volumes of multiple frontal lobe regions These results provide population-level evidence for an association between regional structural alterations in cortical gray matter and problem behaviors reported in children with oSDB. The consistent relationship between oSDB and problem behaviors involving deficits in cognitive control, such as inattention and hyperactivity[14,15] may impact children’s learning and interaction in the classroom[16] Ascertaining this poorly understood link between oSDB and problem behaviors in previous population-based studies requires the interrogation of brainrelated changes common to both[17]. The changes within the cortical gray matter defining the relationship between oSDB and behavioral measures in large population-based cohorts remain unverified Validating this concurrent negative relationship requires robust statistical control for confounding from demographic and socioeconomic factors that often impact the generalizability of small studies[21,22]. No population-based neuroimaging study has investigated whether snoring in children is associated with underlying neuroanatomic alterations following statistical control for common confounders such as socioeconomic status
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
