Poor Sleep Among Preschoolers May Be Tied to Special Ed Needs Later

WEDNESDAY Sept. 5, 2012 -- New research suggests that sleep problems early in life may boost the risk of developmental disabilities by the age of 8.

Researchers found that kids who suffered from problems like sleep apnea and snoring in their infant, toddler and preschool years were more likely to need special education services for conditions such as speech and behavioral problems a few years later.

Although the study found an association between the two factors, it did not prove cause and effect. The higher risk of disabilities could be a statistical fluke, or something else besides sleep problems may explain it. Also, the results were limited because the children, all from England, were 98 percent white.

Still, the findings are worrisome, said study author Karen Bonuck, a professor at Albert Einstein College of Medicine's Department of Family and Social Medicine, in New York City.

"We've got a generation of children potentially at risk from long-term developmental deficits that might occur from these sleep problems," Bonuck said. "Parents need to be vigilant."

The study authors looked at previous research involving thousands of children. Their parents had answered surveys about whether the kids showed signs of sleeping problems -- such as snoring, nightmares, waking in the night and mouth-breathing -- at various ages from 6 months to more than 5 years. The researchers then followed up to track the number of children who appeared to have special education needs at age 8.

Kids with the worst sleeping problems, as defined by the researchers, made up 934 of 11,049 children, about 8 percent. They had the highest risk of having special education needs at age 8, even when researchers adjusted their statistics so they wouldn't be thrown off by factors such as high or low numbers of kids with certain IQs.

In another analysis, 1,825 kids -- out of a total of 13,024 -- had special education needs. More than 71 percent of them had suffered from earlier sleeping problems, compared with 63 percent of all the children.

Do sleeping problems lead to disabilities? Or does some other factor -- the environment in which the kids live, for example, or whether their mother smoked -- lead to both? Or could something else be going on?

It's not clear. But previous research has shown that sleep problems affect the brain, Bonuck said.

Joseph Buckhalt, a professor of education at Auburn University who advocates for better sleep for children, agreed.

Research has shown that sleep deprivation disrupts the making of memories in the brain, he said. But that may not be the entire picture. As he explained, it's possible that genetics could explain both sleep problems and disabilities. "Genetic research in sleep is exploding, and we should soon be able to test that hypothesis," he noted.

What to do?

Buckhalt said pediatricians should routinely monitor kids for sleep problems. "Just asking a few questions is enough to begin the screen. For example, many parents don't think anything about a child who snores. They may even think it is 'cute,'" he said. "But snoring is indicative of poor breathing during sleep."

"Sleep is not just 'rest' where the body needs to restore energy," he said. "The brain is active 24/7, and we now know that not only important aspects of learning and memory happen during sleep, but emotion regulation is also dependent on sleep."

The study appeared online Sept. 3 and in the October print issue of Pediatrics.

More information

For more on children's health, try the U.S. National Library of Medicine.

Posted: September 2012


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