A recent study indicates that teenagers who frequently snore are more likely to show behavior issues such as inattention, rule-breaking, and aggression, yet their cognitive skills remain intact. This research, conducted by scientists at the University of Maryland School of Medicine (UMSOM), is the largest so far that follows snoring patterns in children from elementary age until their mid-teens, offering valuable insights for parents who are uncertain about how to address their child’s snoring.
The study’s results were published in JAMA Network Open.
Researchers evaluated parent-reported data on snoring, along with cognitive and behavioral tests, from nearly 12,000 children participating in the national Adolescent Brain Cognitive Development (ABCD) study—the most extensive investigation into brain development and child health in the U.S. The children, aged 9-10 at the start, underwent yearly assessments until they turned 15 to monitor their snoring frequency, cognitive skills, and behavioral problems.
The research revealed that teenagers who snore three or more times a week tend to face behavioral challenges, including difficulty focusing in school and troubles in social interactions and emotional expression. However, these snorers did not show any differences in language or reading skills, nor in memory or cognitive processing compared to their non-snoring peers. Moreover, the study found that instances of snoring decreased as children aged, even in the absence of any treatment.
According to Amal Isaiah, MD, PhD, MBA, co-author of the study and Chief of Pediatric Otorhinolaryngology at UMSOM, “Adolescence is a time when the brain’s ability to cope with negative influences remains strong, possibly explaining why cognitive functions are preserved despite chronic snoring.” He suggests that if a child displays behavioral issues, it may be beneficial to speak with a pediatrician about a sleep study, potentially before diagnosing them with attention deficit hyperactivity disorder (ADHD). The goal of this research is to clarify the behavioral impacts versus cognitive outcomes of snoring to enhance treatment methods.
Approximately 15% of children in the U.S. experience some form of sleep-related breathing issues, and many of these children are mistakenly diagnosed with ADHD and receive unnecessary stimulant treatment. Dr. Isaiah’s findings build on earlier work linking frequent snoring to brain changes and behavioral concerns throughout childhood, tracking these children into their teenage years.
Regular snoring in children is frequently linked to negative health effects, including poor academic performance, behavioral issues, and a reduced quality of life. While health professionals typically advocate for active treatment of sleep-related breathing disorders, understanding the best management strategies—like surgery to remove adenoids and tonsils (adenotonsillectomy) or other non-surgical methods—remains complicated due to insufficient population data.
Mark T. Gladwin, MD, Dean of UMSOM and Vice President for Medical Affairs at the University of Maryland, noted, “Dr. Isaiah used advanced analytical methods to look at over one million data points, assessing how sleep-related breathing issues affect the developing brains of children through adolescence.” He mentioned the availability of novel computational and AI technologies at the UM Institute for Health Computing, which has significantly accelerated data calculations that used to require months to complete.
The research team plans to leverage AI capabilities at the UM Institute for Health Computing to analyze larger datasets and investigate the causal relationships between snoring and brain development outcomes.
The project received support from the National Heart, Lung, and Blood Institute of the National Institutes of Health (NIH) and various funders associated with the ABCD study.
UMSOM is one of 21 sites involved in the ABCD study, with faculty, including Dr. Isaiah, serving as co-investigators on this ongoing research. Co-authors of the study include Linda Chang, MD, MS, and Thomas Ernst, PhD, who are principal investigators at their respective sites.
