Natural history of snoring and other sleep-disordered breathing (SDB) symptoms in 7-year-old New Zealand children: a follow-up from age 3

We aimed to examine the natural history of snoring and associated symptoms in a community sample of New Zealand children at ages 3 and 7 years, and identify factors associated with habitual snoring at age 7 years. Parent/s of children (n = 839) who completed the community survey about their child's sleep and breathing at age 3 years were re-contacted via mail 4 years later when children were aged 7 years. Parents were asked to complete a follow-up questionnaire which included items relating to their child's sleep and health, and family demographic information. There was a 54.8 % (n = 460) response rate. At follow-up, habitual snoring was prevalent in 9.2 % of the sample, similar to the 11.3 % reported at age 3 years. However, habitual snoring status changed over time; 36.2 % (n = 21/58) remained habitual snorers; 63.8 % (n = 37/58) were no longer snoring habitually, while 5.3 % (n = 21/397) had started habitual snoring since the initial survey. Overall, the reported severity of SDB-related symptoms decreased over time, regardless of initial habitual snoring status. Nonetheless, habitual snoring at follow-up was significantly associated with mouth breathing, sleeping with the neck extended, sweating profusely, night waking, and parent-reported child irritability. Our findings highlight the dynamic nature of SDB, where habitual snoring and related symptoms can develop, remain present, or resolve at different times, over early-mid-childhood years. Given the dynamic nature of habitual snoring over the early childhood years, pediatricians should continue to screen for snoring and sleep apnea on an annual basis throughout childhood.