Abstract
Background: Sleep disordered breathing (SDB) includes snoring and obstructive sleep apnea (OSA) and is common in children, with reported prevalence rates varying widely. Snoring, though less severe than OSA, can have detrimental effects on children’s health. Left untreated. it can lead to elevated blood pressure, neurocognitive and behavioral problems, and adverse impacts on metabolic profiles. Research on infants’ and toddlers’ SDB is limited compared to data on snoring in school-aged children.
Objectives: This prospective study examined the prevalence of snoring during early childhood and the prenatal and postnatal risk factors for this condition. A further aim was to evaluate the prevalence and persistence of snoring during the first two years of life in two Finnish birth cohorts. Additionally, the association between snoring and growth during early childhood and the risk factors for cardiovascular and metabolic disorders, as measured by blood samples at age two, was examined.
Methods: The first study population consisted of 1388 infants who were recruited from the CHILD SLEEP (CS) birth cohort in the Pirkanmaa Hospital District, Finland between 2011 and 2013. Parents completed questionnaires on sleep and background factors prenatally, as well as when the infants were three and eight months old.
The second study included 947 children from the CS and 1393 children from the FinnBrain (FB) birth cohorts. At 24 months of age, both parents were given questionnaires that included sections on the child’s sleep and environmental factors. The third sample consisted of 78 children from the CS cohort who underwent full-night polysomnography (PSG) and whose parents completed a questionnaire on sleep and environmental factors at 24 months. Growth charts were obtained from well-baby clinics, and metabolic blood samples were taken from 31 children.
Results: According to the study, the prevalence of habitual snoring in infants was 3.2% at three months and 3.0% at eight months. Infants who snored at these ages experienced more sleeping difficulties. At three months, snoring infants had shorter sleep duration and more restless sleep than other infants. The risk factors for infants’ snoring were maternal smoking and parental snoring. Additionally, formula feeding, and pacifier use added to the risk of an infant’s snoring at the age of three months.
The combined prevalence of habitual snoring in two birth cohorts at the age of 24 months was found to be 2.3%, which is significantly lower than that reported in previous studies. Children who experienced recurrent infections or asthma were found to be more likely to snore habitually. Moreover, the risk of a child snoring habitually increased when both parents snored every night. A child’s likelihood of habitual snoring was found to be associated with a mother with lower level of education and a lower monthly income.
During the first two years of life, there were no significant differences in growth parameters between the children who snored and the control group. However, children whose total sleep snoring time recorded by PSG was in the highest quartile had lower levels of high-density lipoprotein (HDL) compared to those in the lowest quartile. Linear regression models revealed that snoring time significantly predicted lower HDL and apolipoprotein A1 (ApoA1) levels and higher levels of high- sensitivity C-reactive protein (hs-CRP).
Conclusions: In conclusion, the prevalence of habitual snoring in the Finnish birth cohort was lower than previously reported. Parental snoring, maternal smoking, and socioeconomic factors were linked to infant snoring. Snoring infants were reported to face more sleep difficulties, and independent risk factors included parental snoring, low maternal income, and low maternal education levels. In Finnish children, snoring was associated with adverse effects on the serum metabolic profile. These findings suggest that snoring during early childhood may increase the risk of cardiovascular disease in adulthood.
Objectives: This prospective study examined the prevalence of snoring during early childhood and the prenatal and postnatal risk factors for this condition. A further aim was to evaluate the prevalence and persistence of snoring during the first two years of life in two Finnish birth cohorts. Additionally, the association between snoring and growth during early childhood and the risk factors for cardiovascular and metabolic disorders, as measured by blood samples at age two, was examined.
Methods: The first study population consisted of 1388 infants who were recruited from the CHILD SLEEP (CS) birth cohort in the Pirkanmaa Hospital District, Finland between 2011 and 2013. Parents completed questionnaires on sleep and background factors prenatally, as well as when the infants were three and eight months old.
The second study included 947 children from the CS and 1393 children from the FinnBrain (FB) birth cohorts. At 24 months of age, both parents were given questionnaires that included sections on the child’s sleep and environmental factors. The third sample consisted of 78 children from the CS cohort who underwent full-night polysomnography (PSG) and whose parents completed a questionnaire on sleep and environmental factors at 24 months. Growth charts were obtained from well-baby clinics, and metabolic blood samples were taken from 31 children.
Results: According to the study, the prevalence of habitual snoring in infants was 3.2% at three months and 3.0% at eight months. Infants who snored at these ages experienced more sleeping difficulties. At three months, snoring infants had shorter sleep duration and more restless sleep than other infants. The risk factors for infants’ snoring were maternal smoking and parental snoring. Additionally, formula feeding, and pacifier use added to the risk of an infant’s snoring at the age of three months.
The combined prevalence of habitual snoring in two birth cohorts at the age of 24 months was found to be 2.3%, which is significantly lower than that reported in previous studies. Children who experienced recurrent infections or asthma were found to be more likely to snore habitually. Moreover, the risk of a child snoring habitually increased when both parents snored every night. A child’s likelihood of habitual snoring was found to be associated with a mother with lower level of education and a lower monthly income.
During the first two years of life, there were no significant differences in growth parameters between the children who snored and the control group. However, children whose total sleep snoring time recorded by PSG was in the highest quartile had lower levels of high-density lipoprotein (HDL) compared to those in the lowest quartile. Linear regression models revealed that snoring time significantly predicted lower HDL and apolipoprotein A1 (ApoA1) levels and higher levels of high- sensitivity C-reactive protein (hs-CRP).
Conclusions: In conclusion, the prevalence of habitual snoring in the Finnish birth cohort was lower than previously reported. Parental snoring, maternal smoking, and socioeconomic factors were linked to infant snoring. Snoring infants were reported to face more sleep difficulties, and independent risk factors included parental snoring, low maternal income, and low maternal education levels. In Finnish children, snoring was associated with adverse effects on the serum metabolic profile. These findings suggest that snoring during early childhood may increase the risk of cardiovascular disease in adulthood.
| Original language | English |
|---|---|
| Place of Publication | Tampere |
| Publisher | Tampere University |
| ISBN (Electronic) | 978-952-03-3263-1 |
| ISBN (Print) | 978-952-03-3262-4 |
| Publication status | Published - 2024 |
| Publication type | G5 Doctoral dissertation (articles) |
Publication series
| Name | Tampere University Dissertations - Tampereen yliopiston väitöskirjat |
|---|---|
| Volume | 945 |
| ISSN (Print) | 2489-9860 |
| ISSN (Electronic) | 2490-0028 |