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Snoring May Be Sign of Asthma in Kids

Study finds it causes cough, another asthma indicator

(HealthDay is the new name for HealthScoutNews.)

WEDNESDAY, Aug. 13, 2003 (HealthDayNews) -- Children who snore may be much more likely to have asthma and a nighttime cough than children who do not snore, says a new study from Australia.

Doctors often use night cough as a guide for diagnosing asthma in children, but the findings, which appear in the August issue of Chest, suggest it may be appropriate to treat the snoring first, says one of the study's co-authors.

"Night cough is often taken as a sign of the onset or development of asthma in a young child," says Dr. Colin E. Sullivan, a professor of medicine at the University of Sydney. "Our study shows that such coughing might be being triggered by the child's snoring."

"The study is really an important step," says Dr. James L. Goodwin, an epidemiologist and research assistant professor at the University of Arizona Respiratory Center in Tucson.

Nighttime cough, Goodwin explains, is often used to diagnose asthma in children, but the findings suggest that in some cases snoring may be causing the coughing.

Although snoring may raise the risk of night cough even in children who do not have asthma, Sullivan notes that childhood asthma and snoring do appear to be linked, pointing out that more than 40 percent of children who snored had asthma, compared to about 26 percent of children who did not snore.

"Snorers had almost a doubling of the level of asthma," Sullivan says.

However, Sullivan says the study "does not reveal the nature" of the link between snoring and asthma.

"Because there is such a high association between snoring and asthma, we think it is unlikely that the link can be simply because of an association with the more severe form of snoring." This condition, known as obstructive sleep apnea, stops breathing dozens of times a night by causing the upper airway to completely close during sleep.

"That has made us think that snoring in its own right might be a trigger for asthma," Sullivan says.

Goodwin agrees, but he notes that more research is needed to "tease out" the relationship between asthma, snoring and nighttime cough.

The study included a total of 974 children aged 2 to 5 who lived in New South Wales, Australia. Overall, nearly 11 percent of children snored.

Children who snored at least four nights a week were much more likely to have night cough. While just under 31 percent of all children in the study coughed during the night, almost 62 percent of snoring children had a nighttime cough.

Since night cough is often a symptom of asthma, the researchers examined the link between snoring and night cough in kids with and without the lung disease.

Among children who did not have asthma, nighttime cough was twice as common in children who snored than in those who did not. Similarly, children with asthma who snored were much more likely to have a night cough than asthmatic children who did not snore.

"We do not want to unnecessarily concern parents about snoring, particularly as it is so common," Sullivan says.

"The first thing not to do is panic and think one night of snoring or the occasional snore -- which many children do -- means that they will have lots of problems," Sullivan cautions. "That is not the case."

He advises parents to "calmly observe" their children over several nights to see if snoring is causing breathing difficulty.

"If they are clearly struggling to breathe, are having episodes where they stop breathing, and if they are restless and sweaty during the night, then there is a high probability that they have the more severe form of snoring, that of obstructive apnea, and they should consult their doctor," Sullivan advises.

If a child is a regular snorer, but does not seem to be having breathing difficulties, then parents need only "keep an eye on it" and let their doctor know at their next check-up.

But if a child has other respiratory symptoms, particularly asthma, "you should consider the possibility that the otherwise ordinary snoring is making that asthma worse and you should indicate this when your child is being reviewed because of asthma," Sullivan says.

Goodwin adds that when a child snores four to five nights a week and has other types of problems, including learning difficulties, it is also a good idea to mention the child's snoring to a physician.

More information

Try the American Academy of Pediatrics for information on kids' sleeping problems. The National Sleep Foundation has a page on other sleep disorders.

SOURCES: Colin E. Sullivan, B.Sc., M.B., B.S., Ph.D., professor, medicine, University of Sydney, Australia; James L. Goodwin, Ph.D., epidemiologist and research assistant professor, University of Arizona Respiratory Center, Tucson; August 2003 Chest
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