With the release of a disturbing Monash University study this month, many health practitioners will need to think carefully about using the term Benign Snoring and start actively re-educating parents that snoring is no longer consider harmless, cute or something they may outgrow.
This particular 2017 study found school-aged children who snore had higher blood pressure, increased bad behaviour and a reduced intellectual ability.
"It's the first study which has actually shown this evidence of actual brain damage...We think the longer the child snores, the worse the effects are going to be." Professor Rosemary Horne
The study does not stand alone and is part of a growing body of evidence about the serious detrimental effects of sleep-disordered breathing on the developing brain. A real wake up call for parents is showing them countless studies all revealing their worse nightmare - OSA leading to reduced IQ points and ability to thrive.
Sadly, sleep problems in children are already generally under-recognised by parents. General Practice has taught me they may not mention snoring or nasal obstruction in a consultation unless prompted and even then, as experience has taught me, you have to demonstrate by opening your mouth (yes, I actually tilt my head back, open my mouth and make a snoring noise) or point to a picture of a child mouth-breathing as a visual cue for that light-bulb moment.
They also don’t recognise that learning difficulties, poor appetite, poor concentration, hyperactivity and irritability may also be because of their poor quality sleep, interrupted by reduced cerebral blood flow to oxygenate their brains.
Recognising that sleep disordered breathing as a potential cause for a myriad of presentations is one of the difficult jobs of a family practitioner and one that I am personally seriously keen about.
As a GP, I feel it is our responsibility to start to take sleep screening in kids seriously. As Early intervention is the key, my suggestions to my colleagues out there is one very simple one you can start doing today.
START ADDING THIS Simple Screening Question To Your Routine 4 Year Healthy Kids Check when you are filling in the Blue Book.
Does your child snore or breath with their mouth open?
Plus the Blue Book is another check-point for detecting oral and dental implications of sleep-disordered breathing. A Few extra pointers on recognising mouth breathing can be found here in my previous article with tips on recognising the silent Mouth Breathing epidemic in children.
Any other practical suggestions by inter-speciality health professionals, please feel free to add in comments below - because as I have learnt through developing the collective.care Allergy/ENT/Sleep GP Shared.care specialist Clinics, it takes a team to tackle sleep-disordered breathing in kids.
The Australian. April 18th 2017. Christopher Talbot. Snoring Can Damage Kids' Brains: Study reveals.
G.Nixon et al. Sleep Apnoea in the Child. AFP. Volume 44 (6) 2015 pp 352-355.
Kris L et al. Learning in children and sleep disordered breathing: Findings of the Tuscan Children's Assessment of Sleep Apnoea (TuCASA) Prospective Cohort Study. Journal of the International Neuropsychological Society. Volume 9 (7) 2003 pp 1016-1026.
Biggs SN, Nixon GM, Horne RS. The conundrum of primary snoring in children: what are we missing in regards to cognitive and behavioural morbidity? Sleep Med Rev 2014;18:463–75