Persistent and loud snoring in young children is associated with problem behaviors, according to a new study published online in Pediatrics.

These behaviors include hyperactivity, depression and inattention, according to Dean Beebe, PhD, director of the neuropsychology program at Cincinnati Children's Hospital Medical Center and lead author of the study.

"The strongest predictors of persistent snoring were lower socioeconomic status and the absence or shorter duration of breastfeeding," says Dr. Beebe. "This would suggest that doctors routinely screen for and track snoring, especially in children from poorer families, and refer loudly-snoring children for follow-up care. Failing to screen, or taking a 'wait and see' approach on snoring, could make preschool behavior problems worse. The findings also support the encouragement and facilitation of infant breastfeeding."

The study is believed to be the first to examine the relationship between the persistence of snoring and behavior problems in preschool-age children. Persistent, loud snoring occurs in approximately one of every 10 children.

Dr. Beebe and colleagues at Cincinnati Children's studied 249 children. The researchers surveyed the children's moms about their kids' sleep and behaviors. The study showed that children who snored loudly at least twice a week at the age of 2 and 3 had more behavior problems than children who either don't snore or who snored at 2 or 3 but not at both ages.

"A lot of kids snore every so often, and cartoons make snoring look cute or funny. But loud snoring that lasts for months is not normal, and anything that puts young kids at that much risk for behavioral problems is neither cute nor funny," says Dr. Beebe. "That kind of snoring can be a sign of real breathing problems at night that are treatable. I encourage parents to talk to their child's doctor about loud snoring, especially if it happens a lot and persists over time."

Infant breastfeeding, especially over longer periods of time, seemed to protect children against persistent snoring, even after taking into account other factors, including family income.

The study was supported by grants from the National Institute of Environmental Health Sciences (R01 ES015517-01A1, P01 ES11261).