A prospective birth cohort study (n=249) was carried out to clarify whether persistent snoring in two to three-year-olds is associated with behavioural and cognitive development, and to identify predictors of transient and persistent snoring.

Parents reported loud snoring ≥ twice weekly at two and three years of age and, based on this, children were defined as non-snorers, transient snorers (snored at two or three years of age, but not both), or persistent snorers (snored at both ages). The groups were compared using validated measures of behavioural and cognitive functioning. Potential predictors of snoring included child race and gender, socio-economic status (parent education and income), birthweight, prenatal tobacco exposure (maternal serum cotinine), childhood tobacco exposure (serum cotinine), history and duration of breastmilk feeding, and body mass relative to norms.

The researchers found that persistent snorers had significantly higher reported overall behaviour problems, particularly hyperactivity, depression, and inattention. Non-snorers had significantly stronger cognitive development than transient and persistent snorers in unadjusted analyses, but not after demographic adjustment. The strongest predictors of the presence and persistence of snoring were lower socio-economic status and the absence or shorter duration of breastmilk feeding.

They conclude that persistent, loud snoring was associated with higher rates of problem behaviours. These results support routine screening and tracking of snoring, especially in children from low socio-economic backgrounds; referral for follow-up care of persistent snoring in young children; and encouragement and facilitation of infant breastfeeding.

Beebe DW, Rausch J, Byars KC et al (2012). Persistent Snoring in Preschool Children: Predictors and Behavioral and Developmental Correlates. Pediatrics. published 13 August 2012, 10.1542/peds.2012-0045