title: The development of snoring and sleep related breathing distress from 4 to 6 years in a cohort of Swedish children.
abstract: BACKGROUND
  Snoring is common among both children and adults and a sign of sleep disordered breathing (SDB). Adenotonsillectomy is often the solution offered, although the effect is uncertain. There are also some who say that young children who snore will outgrow it even without treatment. The present investigation compares snoring and co-founding symptoms in parental reports for a cohort of children at age 4 and at age 6 years.
  
  
  METHODS
  A cohort of 4 year old chidren (615) was investigated with respect to SDB [B. Löfstrand-Tideström, B. Thilander, J. Ahlqvist-Rastad, O. Jakobsson, E. Hultcrantz, Breathing obstruction in relation to craniofacial and dental arch morphology in 4 year old children, Eur. J. Orthod. 21 (1999) 323-332]. Each child was given a questionnaire. Those reporting significant symptoms also received a clinical and an orthodontic examination. Forty-eight children were diagnosed with SDB; of these 28 were operated with adenoidectomy and/or tonsillectomy. After 2 years, the same questionnaire was administered and the same children as before were further examined as well as those newly reporting significant symptoms. The results from the two occasions were compared.
  
  
  RESULTS
  Eighty-three percent (509) of the original cohort participated. The frequency of snoring had changed from 53 to 46% for the group as a whole (p<0.05). Significant gender differences in co-founding symptoms were seen. Severity of snoring had changed on an individual basis in half of the cases; some recovered, others got worse. Of the children with SDB at 4 years who were operated, 14/28, did not snore at all, compared to 3/18 of the non-operated (p<0.05).
  
  
  CONCLUSIONS
  Children who snore at the age 4 seldom "grow out of it" by age 6 and still show other signs of sleep related distress as well. Surgery does not always cure the snoring, thus postoperative follow-up is important. Since new cases develop during this age period, early intervention is not enough.
authors.affiliation: University of Linkoping, 581 85 Linkoping, Sweden.
authors.forename: Britta
authors.initials: B
authors.lastname: Löfstrand-Tideström
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Hultcrantz
mesh_terms: D000233:Adenoidectomy / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012891:Sleep Apnea Syndromes / Q000453:epidemiology* / Q000503:physiopathology; D012913:Snoring / Q000453:epidemiology* / Q000503:physiopathology; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D014068:Tonsillectomy / Q000706:statistics & numerical data