Obstructive sleep apnea makes it nearly impossible to get a good night's sleep. Imagine air stopping in your throat, prompting you to choke and wake up so you can reopen your airways…100 times a night. Not to mention sleep apnea in children is associated with increased risk for other complications, including obesity, AHDH, and heart disease. If that weren't reason enough to seek treatment, maybe this will: A recent study conducted by the University of Michigan Health System found remedying a child’s sleep apnea improves their behavior, no matter if they have a low or high IQ.

"When a clinician sees a pediatric patient who has a problem in school, they ask about sleep," said Dr. Ronald Chervin, neurologist and director of the University of Michigan Sleep Disorders Center, in a statement. "We wondered, in high-performing children, do we still need to worry about snoring or sleep issues?"

Chervin and his colleagues recruited 147 children between the ages of 3 and 12 who were scheduled to undergo an adenotonsillectomy — a procedure that removes the patient’s tonsils and adenoids. Adenotonsillectomy is usually performed when children are suspected of having obstructive sleep apnea, which is characterized by enlarged tonsils and adenoids that stop children from breathing up to ten seconds throughout the night.

Researchers conducted sleep tests that monitored brain wave patterns, eye movements, heart rhythm, muscle activity, airflow out the nose and mouth, chest movements, and snoring. They then asked parents to grade their child's behavior with regard to inattention, hyperactivity, social problems, and perfectionism. The results showed children from both low and high IQ groups experienced similar behavioral improvements when they were reevaluated six months after the adenotonsillectomy.

"Regardless of intellectual level, we can expect to see some behavioral improvement along with better sleep," said Dr. Bruno Giordani, a professor of neurology, psychiatry, psychology, and nursing. "Once behavior improves, attention in school improves, and emotional ability and behavioral and impulsivity control improve."

Although children with high IQs were included in the study, identifying children with high IQs and obstructive sleep apnea is difficult in practice because they don't typically show problems with school performance. Spotting a child who is struggling from a lack of good sleep is a lot tougher than an adult who almost certainly will appear to be tired the next day, if not outright complain about it. Children, on the other hand, often react to a lack of sleep by being hyperactive the next day.

"Children with obstructive sleep apnea are fidgeting and not able to stay on task, because they're doing anything they can to stay awake," said Dr. Seockhoon Chung. "Even when those behavioral problems are minimal, improvement is still possible."

Studies have shown improved behavioral problems related to sleep apnea is imperative to ensuring these behaviors don't carry over into teenage years. A study presented at SLEEP 2012 found children with untreated obstructive sleep apnea suffered more from long-term behavioral problems, including aggression, hyperactivity, difficulty in controlling their behavior, and many other social and behavioral problems.

Source: Chung S, Giordani B, Chervin R, et al. Improved behavior after adenotonsillectomy in children with higher and lower IQ. International Journal of Pediatric Otorhinolaryngology. 2016.