Sleep Problems Linked to More Special Ed

Young Children Who Snore or Have Trouble Sleeping Through the Night are More Likely to Need Special Education

By Rita Rubin
WebMD Health News

Reviewed by Hansa D. Bhargava, MD

Sept. 4, 2012 -- Young children who snore or have trouble sleeping through the night are more likely to need special education, a new study shows.

Researchers looked at more than 11,000 children in southwest England. They found that breathing problems during sleep, such as snoring, or problems such as regularly refusing to go to bed, waking up in the night, and having nightmares through age 5 were associated with a greater chance of needing special education at age 8.

Overall, breathing problems during sleep were linked to a nearly 40% increased risk of needing special education. Children with the worst breathing problems had a 60% greater need for special education.

Screening for Sleep Problems

Last week, the American Academy of Pediatrics issued new recommendations urging that all children and teens who snore regularly be screened for sleep apnea. "If left untreated," the group said, sleep apnea "can result in problems such as behavioral issues, cardiovascular problems, poor growth and developmental delays."

A common treatment is removal of the tonsils and adenoids, according to the recommendations. Obesity can also be a risk factor, so doctors might also recommend weight loss, the group says.

Karen Bonuck, PhD, who led the new study, says parents who are concerned about their children's sleep should tell their doctors.

And it's not just parents who should be alert, Bonuck says. Day care staff who notice at nap time that one child snores more than the others should notify the parents.

Could Developmental Problems Be to Blame?

Dean Beebe, PhD, a professor of psychology at the University of Cincinnati, calls breathing problems during sleep "a bit more compelling" explanation for poor development than an inability to sleep through the night.

Breathing problems during sleep in infancy and early childhood could lower oxygen to the brain at a key period of development, Beebe says. In a study of 249 children published last month in Pediatrics, Beebe found that those who were heavy snorers at 2 and 3 years of age were more likely to have problems such as hyperactivity, depression, and inattention.

But, Beebe says, problems such as autism are tied to poor sleep, so it's not clear whether poor sleep or an underlying problem is the reason poor sleepers are more likely to need special education.

However, even after accounting for IQ, Bonuck says, she still found a connection between poor sleep and an increased risk of needing special education.

Bonuck's study appears online in Pediatrics.


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SOURCES: Karen Bonuck, PhD, professor of family and social medicine and of obstetrics and gynecology and women's health, Albert Einstein College of Medicine, New York. Dean Beebe PhD, professor of psychology, University of Cincinnati.

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