Abstract
Mouth breathing syndrome is very common among school-age children, and it is possibly related to learning difficulties and low academic achievement. In this study, we investigated working memory, reading comprehension and arithmetic skills in children with nasal and mouth breathing. Analytical cross-sectional study with control group conducted in a public university hospital. 42 children (mean age = 8.7 years) who had been identified as mouth breathers were compared with a control group (mean age = 8.4 years) matched for age and schooling. All the participants underwent a clinical interview, tone audiometry, otorhinolaryngological evaluation and cognitive assessment of phonological working memory (numbers and pseudowords), reading comprehension and arithmetic skills. Children with mouth breathing had poorer performance than controls, regarding reading comprehension (P = 0.006), arithmetic (P = 0.025) and working memory for pseudowords (P = 0.002), but not for numbers (P = 0.76). Children with mouth breathing have low academic achievement and poorer phonological working memory than controls. Teachers and healthcare professionals should be aware of the association of mouth breathing with children's physical and cognitive health.
Highlights
Children with mouth breathing were compared with a control group in relation to a series of cognitive tasks such as reading comprehension, arithmetic and phonological working memory
The mouth breathing group included children with one or more of the following characteristics: (1) obstructive or irritating nasal signs lasting more than three months; (2) obstructive tonsils; (3) inferior turbinate hypertrophy; and (4) obstructive septal deviation
The sample comprised 55 children divided into two groups according to the otorhinolaryngological evaluation: 42 children were identified as presenting mouth breathing (MB group) and 13 children, nasal breathing
Summary
Mouth breathing syndrome is a very common condition that affects around 50% of Brazilian children at school age.[1,2] It is characterized by nasal obstruction symptoms (e.g. hyponasal speech, sleep fragmentation, snoring during sleep and drooling) and a set of body adaptations, such as forward head posture and low forward tongue position.[3,4] The main causes are allergic rhinitis, palatine and/or pharyngeal tonsil hypertrophy, and septal deviation.[3,4]. Little is known about working memory problems in children with mouth breathing. Working memory is the cognitive system responsible for temporary storage and processing of information during complex cognitive tasks, and it is crucially involved in reading comprehension, arithmetic skills and academic achievement.[19,20,21,22] there are strong reasons to expect that children with mouth breathing may have working memory problems. Children with mouth breathing were compared with a control group in relation to a series of cognitive tasks such as reading comprehension, arithmetic and phonological working memory
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