By Sari Harrar

Health-threatening snoring and obstructive sleep apnea -- pauses in breathing throughout the night -- aren't just problems for grown-ups. In a new study, researchers say night-time wake-ups and other clues could help parents get the right diagnosis and help for little kids with often-overlooked breathing problems during sleep.

Researchers from Albert Einstein College of Medicine of Yeshiva University tracked the sleep quality and night-time sleep disturbances of over 11,000 British kids from the time they were 18 months old until just before their 5th birthday.

Parents were asked if kids had been diagnosed with sleep apnea or snoring that interfered with sleep. To help identify at-home clues for these conditions, the researchers also asked parents whether their child had any of these unexpected signs of an underlying sleep problem:

  • Refusing to go to bed

  • Regularly waking up early

  • Difficulty sleeping

  • Nightmares

  • Getting up after being put to bed

  • Waking up during the night

Children with five or more of these behaviors simultaneously were considered to have a clinically significant behavioral sleep problem. The study found a strong association between night-time sleep issues a parent would notice and a more serious sleep-disordered breathing problem: Up to 40% of kids with significant behavioral sleep problems had sleep-disordered breathing.

What's the connection? The researchers say getting up at night or refusing to go to bed won't cause sleep-disordered breathing, but a breathing problem could trigger those issues. They also warn that parents who respond anxiously to late-night wake-ups and the like can perpetuate those habits in kids, even after underlying breathing problems are fixed.

"It's important that we pay attention to how our children are sleeping," notes Karen Bonuck, Ph.D., professor of family and social medicine and of obstetrics & gynecology and women's health at Einstein."There's ample evidence that anything that interrupts sleep can negatively affect a child's emotional, cognitive, behavioral and academic development. Fortunately, snoring and apnea are highly treatable, and there are many effective interventions for behavioral sleep problems…Our findings should raise awareness among parents and physicians that if a child is sleeping poorly, they should delve deeper to see if there is an unrecognized respiratory-related sleep problem."