sleep apnea

  • Sleep apnea associated with 50% higher risk of memory problems.

    Original Article | Medical News Today

    • A new study analyzes the impact of sleep apnea symptoms on memory and thinking.
    • Sleep apnea is a sleep disorder that sometimes causes people to stop breathing.
    • The study subjects participated in a survey where they reported any symptoms of sleep apnea and difficulty with remembering things.
    • The study shows an association between sleep apnea symptoms and a higher rate of memory and thinking problems.

    Getting a good night’s sleep is important for many reasons, from having the energy to go about one’s daily tasks to optimal brain performance.

    Sleep apnea can interfere with this, and according to the National Council on Aging, it may impact around 39 million adults in the United States.

    While experts know sleep apnea can impact quality of life and even contribute to mood disordersTrusted Source, there is still more to learn.

    A researcher based in Boston recently conducted a cross-sectional study to determine whether a correlation between sleep apnea and thinking and memory problems exists.

    The findings showed that having sleep apnea symptoms correlated with a 50% increase in memory and thinking problems.

    The researcher will present the findings at the American Academy of Neurology’s Annual Meeting in April 2024. The research hasn’t yet been published in a peer-reviewed journal.

    Sleep apnea linked to thinking and memory issues

    Most people with sleep apnea have obstructive sleep apnea (OSA), but some experts have said that OSA is underdiagnosed.

    For instance, researchersTrusted Source note, “it is believed that more than 85% of patients with clinically significant OSA have never been diagnosed.”

    With the notion that sleep apnea could be underdiagnosed in mind, researcher Dr. Dominique Low wanted to learn more about a possible connection between sleep apnea and cognition. Dr. Low works at Boston Medical Center in Massachusetts and is a member of the American Academy of Neurology.

    Dr. Low pulled data from a government-funded survey called the 2017–18 National Health and Nutrition Examination Survey (NHANES) to establish a potential link between sleep apnea and thinking and memory.

    The study participants included 4,257 adults ages 20 and older. Of the questionnaires they completed for the NHANES, they answered questions about sleep quality, memory, and thinking.

    Dr. Low used the data from these questionnaires to determine how people who reported sleep apnea symptoms compared to people without these symptoms.

    The participants also answered questions on their memory quality, whether they had any periods of confusion, and if the participants thought they had trouble making decisions.

    A total of 1,079 participants reported sleep apnea symptoms, including snoring and gasping for breath while asleep.

    Of people who indicated they had sleep apnea symptoms, 33% also reported symptoms of memory and thinking problems. This is significantly higher than the number of people without sleep apnea symptoms who reported such problems, which was only 20% of that group.

    After adjusting for other factors like age, race, and gender, Dr. Low observed that people with sleep apnea symptoms had a 50% higher chance of having thinking and memory issues compared to participants who didn’t report sleep apnea symptoms.

    “Our study found participants who had sleep apnea symptoms had greater odds of having memory or thinking problems,” Dr. Low said in a news release. “These findings highlight the importance of early screening for sleep apnea.”

    Despite the implications of these findings, it’s important to note that a correlation does not indicate causation. Scientists must conduct further research that does not rely solely on self-reported symptoms to establish the effects of sleep apnea symptoms on memory and thinking.

    Reducing the risk of cognitive decline

    Dr. Joey R. Gee, a neurologist at Providence Mission Hospital in Mission Viejo, California, spoke with Medical News Today about how sleep apnea may impact memory. Dr. Gee was not involved with the study.

    “Apnea may have an impact due to poor oxygenation through the night or also impairing appropriate sleep cycles with frequent arousals,” Dr. Gee noted. “Impaired executive functions, such as working memory and attention through the day, are greatly impacted.”

    Dr. Gee said that while untreated sleep apnea may impact cognitive function, the risk could be reduced with appropriate treatment.

    “Just as untreated sleep apnea increases the risk of impairment in executive function and attention, treatment can substantially reduce the risk of progressing cognitive decline,” Dr. Gee said.

    Dr. Thomas Kilkenny, the director of the Institute of Sleep Medicine at Staten Island University Hospital in New York, not involved in the study, emphasized the importance of treating sleep apnea as soon as it is detected.

    “If the patient can be treated early in OSA, these brain damages will not occur,” Dr. Kilkenny told MNT. “There will be a decrease in the amount of cognitive decline in OSA patients.”

    Dr. David Merrill, a geriatric psychiatrist and director of the Pacific Neuroscience Institute’s Pacific Brain Health Center at Providence Saint John’s Health Center in Santa Monica, California, not involved with the study, shared his thoughts on the findings with MNT:

    “With high quality, restorative sleep, the brain’s function is enhanced and protected as we age,” explained Dr. Merrill. “If sleep is chronically disrupted, this can lead to a number of health issues, including headaches, fatigue, and memory loss that worsens over time. The disrupted, poor-quality sleep seen in sleep disorders leads to both acute and chronically worsening changes in the brain. Normally, a good night’s sleep literally allows for repair and restoration of brain function to the levels seen at the beginning of the prior day.”

    Dr. Merrill also spoke about the importance of treating sleep apnea and noted that it is a risk factor for developing dementia. While that may sound scary, he said that using a CPAP machine can help reduce risk.

    Research studiesTrusted Source have shown that even 4 hours per night using a CPAP device results in significantly less worsening of cognitive decline over time,” said Dr. Merrill.

    What to know about sleep apnea

    Sleep apnea, including obstructive sleep apnea and central sleep apnea, can affect people of all ages but, as the National Council on Aging notes (link above), it is most prevalent in middle-aged and older adults.

    Some symptomsTrusted Source of sleep apnea a person may detect on their own include:

    • sleepiness during the day
    • headaches
    • difficulty focusing

    A person’s partner may notice additional symptoms such as snoring or gasping for breath while asleep.

    “Signs of obstructive sleep apnea are usually readily apparent,” Dr. Kilkenny said.

    “Loud snoring, restlessness, and daytime fatigue are the hallmarks of OSA,” he noted. “If someone snores even to a minor degree, they should bring this to the attention of their physician so they can get tested for OSA before damage occurs.”

    People with sleep apnea can treat it using a continuous positive airway pressure (CPAP) machine.

    They may also try to improve symptoms by making lifestyle changes such as losing weight. They may also have surgery or use an oral appliance.

  • Philips Suspends U.S. Sales of Breathing Machines After Recall

    Original Post | New York Times

    Under a settlement with regulators, the company must revamp some operations before resuming sales of its CPAP and ventilator devices in the United States.

    Philips Respironics announced on Monday that it would halt sales of all of its breathing machines in the United States after reaching a settlement with the Food and Drug Administration over continuing problems with the devices.

    Millions of the company’s ventilators and CPAP machines, used to ease breathing at night, were recalled after reports that they blew bits of foam and potentially toxic gases into consumers’ airways.

    Under the settlement, Philips said it would have to meet a list of standards in a “multiyear” plan before it could resume business in the United States. The company said further details would be disclosed when the agreement was finalized in court. But it added that it would continue to repair existing devices and provide service for people using them.

    The company initially began the recall of millions of devices in June 2021 and paused sales of new sleep therapy machines to the United States, according to Steve Klink, a spokesman for Philips. At the time, the company and the F.D.A. cited the potential for serious injury or permanent impairment from the potentially cancer-causing chemicals emitted from the devices.

    The company has since released results of additional testing, saying the devices were “not expected to result in appreciable harm to health in patients,” and it said it was continuing to conduct tests. The F.D.A. has pushed back on some of the company’s updated claims, and at one point called them “unpersuasive.” Philips has also faced continuing scrutiny and undertaken more recalls in its attempts to upgrade the devices.

    Dr. Jeff Shuren, director of the F.D.A.’s device division, said the agency could not comment until the agreement was finalized and filed with the court.

    The initial recall affected about 15 million breathing machines produced since 2006, though roughly five million were still in circulation in mid-2021.

    With replacements not immediately available, the recall caused confusion and upset for many doctors and patients. Many struggled to weigh the risk of continuing to use a faulty device against the peril of sleeping with impaired breathing.

    Millions of people suffer from sleep apnea, or interrupted breathing, which is associated with elevated rates of strokes, heart attacks and possible cognitive decline. Recalled machines included CPAP, or continuous positive airway pressure, machines; BiPap devices; and ventilators.

    Philips, which is based in Amsterdam, disclosed that it had reached an agreement, or a consent decree, that was brokered with the U.S. Justice Department and the F.D.A., along with the announcement of its fourth-quarter earnings. The company said it wrote down about 363 million euros related to the cost of completing the settlement requirements. Its stock, which trades in the United States, was down about 7 percent Monday morning.

    The company said it would continue to sell its products in other countries.

    Thousands of patients have since sued Philips, claiming that the machines led to a wide range of respiratory and other ailments, including allegations of deaths from lung cancer. In September, the company reached a $479 million settlement with plaintiffs that was meant to cover the financial losses related to repairing or replacing the machines. Litigation over illnesses and medical costs is still pending.

    Christina Jewett covers the Food and Drug Administration. She is an award-winning investigative journalist and has a strong interest in how the work of the F.D.A. affects the people who use regulated products. More about Christina Jewett

  • Why people should prioritize sleep quality over quantity.

    By Analisa Novak – February 19, 2024 / 11:59 AM EST / CBS News

    When it comes to maintaining heart health, it’s not just how long you sleep — it’s how well you sleep that matters equally, if not more, said Dr. Shelby Harris, a behavioral sleep psychologist and clinical associate professor at Albert Einstein College of Medicine.

    “Poor quality sleep really can influence our heart health as well,” Harris told “CBS Mornings” in an interview during American Heart Month

    Harris said the body’s balance of ghrelin and leptin, hormones that regulate hunger, is also disrupted by poor sleep, leading to increased consumption of high-sugar and high-fat foods. 

    Sleep disorders like sleep apnea and insomnia are closely linked to heart health. Sleep apnea, characterized by snoring and breathing pauses, affects both men and women, though women are evaluated less frequently for it. 

    Strategies for improving sleep quality include limiting alcohol and caffeine intake, reducing screen time before bed and managing how much liquid you drink before bed. 

    “Once you have better quality then we try to work on the quantity of sleep possible,” Harris said.

    For those struggling to achieve a longer sleep duration, getting a good quality amount of sleep but shorter is ideal when you first are trying to tackle this goal. 

    “For some people, I might have them go to bed later and then I might slowly have them go to bed earlier over time as opposed to that shifting back and forth. Because that can create a lot of problems for people as well,” she said. 

    Harris said that sleeping pills and aids are not ideal for most people, but said cognitive-behavioral therapy for insomnia may offer an alternative solution to medication. 

    She said most people try four to eight sessions of the therapy and if that doesn’t work, then she would recommend sleeping aids. 

    “You work on not just the hygiene but you work on the timing of sleep. … We work on thoughts about sleep, a lot of people put pressure on themselves to sleep and they worry about what’s going to happen if they don’t sleep and so we work on that aspect,” she said. 

    Harris said dietary choices also play a role in a good night’s sleep. She said people should avoid consuming large or heavy meals, such as a big dinner, before going to bed.

    Instead, opting for a small, light snack that includes a mix of protein and carbohydrates can be beneficial. “That’s a really good mix to help you throughout the night so you don’t wake up hungry, which a lot of people do as well,” said Harris.

  • Can obstructive sleep apnea negatively impact brain health?

    Original Article | Medical News Today

    • Obstructive sleep apnea, the most common type of sleep breathing disorder, is a risk factorTrusted Source for cerebrovascular disease, conditions that affect blood vessels in the brain.
    • Obstructive sleep apnea is also linkedTrusted Source to mild cognitive impairment and Alzheimer’s disease, but the mechanisms underlying this association are not well understood.
    • Dementia is also associated with abnormalities in the brain’s white matter that are hallmarks or markers of cerebrovascular diseases.
    • A recent observational study shows that severe obstructive sleep apnea and reduced deep sleep were independently associated with white matter abnormalities related to cerebrovascular diseases in cognitively unimpaired older adults.
    • These findings show that severe obstructive sleep apnea and poor sleep quality can lead to an increase in the biomarkers of cerebrovascular disease, potentially increasing the risk of cognitive decline and stroke.

    Obstructive sleep apnea is the most common type of sleep-breathing disorder that affects nearly a billionTrusted Source individuals across the globe.

    A recent study published in Neurology suggests that obstructive sleep apnea and a reduction in deep sleep, also known as slow-wave sleep, were independently associated with an increase in white matter abnormalities in the brain.

    The white matter abnormalities assessed in the study are known markers of cerebrovascular disease and are also observed in mild cognitive impairment and Alzheimer’s disease.

    The findings from this observational study thus suggest that obstructive sleep apnea and poor sleep quality could potentially lead to increased white matter abnormalities, subsequently increasing the risk of dementia and stroke.

    The study’s author Dr. Diego Carvalho, a neurologist at the Mayo Clinic in Rochester, MN, told Medical News Today:

    “White matter abnormalities increase with aging and may contribute to cognitive decline, dementia, and stroke. Since there is no treatment to reverse or slow them down other than risk factor prevention, it is important to understand what may contribute to their development.”

    “In our study, we found that severe sleep apnea and decreased deep sleep were associated with more white matter abnormalities. Although we cannot infer a direct causal relationship with a cross-sectional study design, the findings raise the possibility that sleep interventions may prevent the progression of white matter disease. Although there is already compelling evidence that sleep apnea is involved in white matter abnormalities, the potential role of slow-wave sleep (or deep sleep) in white matter health is much less understood,” added Dr. Carvalho.

    Sleep quality and dementia

    Obstructive sleep apneaTrusted Source is a sleep-breathing disorder characterized by episodes of interruption of breathing due to partial or complete blockage of the upper airway. The episodes of reduced breathing are known as hypopnea, whereas apnea refers to events involving a complete blockage of the upper airway.

    The apnea-hypopnea index (AHI) describes the number of apnea and hypopnea events per hour. Specifically, obstructive sleep apnea involves at least five such episodes of apnea or hypopnea per hour.

    The interruption of breathing triggers a compensatory response that leads to arousal from sleep. Thus, obstructive sleep apnea leads to sleep disturbances and an experience of feeling unrefreshed after sleep.

    Several studies have shown that poor sleep quality is associated with an increased risk of cognitive decline and dementia.

    The accumulation of misfolded deposits of the amyloid-beta and tau proteins is a hallmark of Alzheimer’s disease. A previous study showed a higher accumulation of the amyloid-beta protein in the brains of individuals experiencing excessive daytime sleepiness.

    In contrast, a brain imaging studyTrusted Source showed that cognitively unimpaired individuals with higher tau levels in their brains were at an increased risk of obstructive sleep apnea.

    These studies suggest a bidirectional relationship between sleep quality and pathological changes associated with Alzheimer’s disease.

    Why white matter changes have an impact

    In addition to the accumulation of misfolded proteins, individuals with dementia also show damage to neurons.

    The brain tissue can be categorized into white matter and gray matter. The gray matter consists of the cell bodies of neurons, whereas the white matter consists of axons that transmit information.

    Several of the axonal processes in the white matter are encased in an insulating layer called the myelin sheath. The myelin sheath gives white matter its color and allows the axons to conduct electrical impulses more rapidly and efficiently.

    Individuals with dementia and mild cognitive impairment show abnormalities in the white matter. Some of these white matter abnormalities, such as white matter hyperintensitiesTrusted Source and a decline in the integrity of the white matter tract, are also markers for cerebrovascular diseases, which are diseases of the blood vessels in the brain.

    White matter hyperintensities are hyperintense regions identified using MRI that represent lesions of white matter generally caused by cerebral small vessel disease.

    The integrity of the white matter tract is measured in terms of fractional anisotropy using a technique called diffusion tensor imaging. These white matter abnormalities due to damage to blood vessels may contribute to cognitive decline.

    Sleep and cerebrovascular health

    Sleep disorders such as obstructive sleep apnea are also associatedTrusted Source with increased risk of cerebrovascular diseases. Thus, sleep disorders could potentially lead to cerebrovascular disease-related white matter abnormalities and increase the risk of dementia.

    For instance, there is evidence from the authors’ own work showing that individuals with daytime sleepiness have elevated levels of the neurofilament light chain protein in their blood, though research evidence is contradictoryTrusted Source.

    The neurofilament light chain protein is a protein associated with the myelin sheath covering the axons of neurons. Thus, elevated neurofilament light chain protein levels suggest damage to myelinated axons and, thus, white matter damage.

    In the present study, the researchers examined the association between sleep quality, including the presence of obstructive sleep apnea, with white matter abnormalities in the brain of cognitively unimpaired individuals.

    A study on sleep and cognitive impairment

    The new study consisted of 140 individuals participating in the Mayo Clinic Study of Aging (MCSA), a population-based cohort study that aims to characterize the prevalence and risk factors associated with mild cognitive impairment and dementia.

    The study included individuals who had previously undergone a brain MRI scan and at least one polysomnography test as a part of the MCSA study.

    A polysomnographic study is a sleep study that assesses multiple parameters associated with sleep, including brain waves, breathing and heart rate, and blood oxygen levels. The average duration between the brain MRI scan and the polysomnography test was 1.74 years.

    The researchers aimed to only include participants who were cognitively unimpaired at the time of both the MRI and the polysomnography test. The study consisted of 90.7% of the participants who were cognitively unimpaired at the time of both assessments.

    Only participants with obstructive sleep apnea were included in the study. These participants were categorized as having either mild, moderate, or severe obstructive sleep apnea on the basis of the number of episodes of apnea and hypopnea per hour.

    Sleep quality and cerebrovascular biomarkers

    The researchers first examined the association between sleep patterns and white matter abnormalities. Sleep can be dividedTrusted Source into the non-rapid eye movement (NREM) and rapid eye movement (REM) phases.

    Furthermore, the NREM phase can be further subdivided into N1-N3 phases, with the N1 being the lightest sleep phase and N3 involving deep sleep. These phases show differences in their patterns of brain waves, eye movements, and muscle tone.

    Using brain waves collected during polysomnography, the researchers found that a lower fraction of time spent in the N3 phase or slow wave sleep was associated with elevated levels of white matter damage.

    This association was present after accounting for variables such as age, sex, genetic risk of Alzheimer’s disease, and cardiovascular risk factors.

    In a separate analysis, the researchers looked at the association between obstructive sleep apnea severity and markers of white matter damage. They categorized patients as either having severe or mild-to-moderate obstructive sleep apnea and matched individuals from the two groups for age, sex, and N3 sleep levels for this analysis.

    Individuals with severe obstructive sleep apnea showed higher white matter abnormalities than those with mild-to-moderate.

    Individuals in the two groups did not show differences in cardiometabolic risk factors, but the individuals with severe obstructive sleep apnea showed higher arousal levels. This indicates the fragmentation of sleep in individuals with severe obstructive sleep apnea.

    Dr. Sandra Narayanan, a board-certified vascular neurologist and neuro-interventional surgeon at Pacific Stroke & Neurovascular Center at Pacific Neuroscience Institute in Santa Monica, CA, not involved in the research told us that these findings show that, while obstructive sleep apnea is associated with cardiovascular disease, it could independently increase the risk of cerebrovascular diseases.

    Dr. Narayanan said: “[Obstructive sleep apnea] is an important vascular comorbidity, as it is significantly associated with an increased risk of hypertension, cardiovascular disease, and stroke. This study demonstrates a separate association of OSA with imaging biomarkers of cerebrovascular disease.”

    Strengths and limitations

    Some of the previous studies showing a link between sleep quality and white matter abnormalities have not controlled for cardiometabolic risk factors. These cardiometabolic factors can increase the risk of cerebrovascular conditions, such as stroke, thus potentially biasing the results.

    One of the strengths of the present study was that the researchers controlled for cardiometabolic risk factors.

    The authors acknowledged that their study had a few limitations. They noted that they only collected sleep data during the initial few hours of sleep.

    This could have biased the data on sleep patterns. For instance, the period of REM sleep tends to increase during the night, whereas the duration of deep sleep tends to decline.

    Dr. Narayanan noted: “While the imaging biomarkers of CVD noted in this study were not independently linked during the course of this study to the development of incident stroke, the presence of white matter hyperintensities is strongly associated with cognitive impairment, stroke, and death in numerous other studies.”

    “Fractional anisotropy (FA) is a marker of white matter integrity, as noted in diffusion tensor imaging (DTI),“ she explained. “Decreased FA is associated with other neurodegenerative disorders such as Alzheimer’s dementia and Parkinson’s disease, but has a poor prognostic value for motor recovery following stroke.”

    The authors also noted that the study had an observational design, and further studies are needed to show that obstructive sleep apnea and reduced slow-wave sleep can cause an increase in the biomarker of cerebrovascular disease.

  • From Caffeine to Screens: Everyday Habits That Might Be Ruining Your Sleep

    A peaceful night’s sleep often remains an elusive dream for many, with daily habits being significant culprits. The subtle interplay of what we consume, our digital indulgence, and even our bedtime activities can significantly influence the quality of our slumber.

    What Habits Could Ruin Your Sleep?

    Take caffeine, for example. Renowned as a morning pick-me-up, caffeine does more than just jolt you awake. Research suggests that caffeine can linger in your system for 3 to 5 hours, potentially disrupting the sleep cycle. To circumvent this, consider wrapping up your caffeine consumption by early afternoon. If you’re hankering for a warm drink later on, herbal tea, notably devoid of caffeine, could be your go-to.

    Then there’s the omnipresent screen. The blue light emitted from our beloved devices is notorious for meddling with our melatonin production, a hormone pivotal for sleep. Frequent screen interaction, particularly in the twilight hours, could spell sleep trouble. Employing blue light filters on gadgets or designating the hour before bed as screen-free could pave the way for better rest.

    Late-night munching, though seemingly harmless, brings its set of sleep challenges. Certain foods, notably those rich in spice or acid, can potentially disrupt sleep. In case of late-night hunger pangs, foods like bananas or almonds, known to promote sleep, might be apt choices.

    But Wait, There’s More

    Alcohol, contrary to popular belief, isn’t the sleep ally it’s made out to be. While it might propel you into slumber initially, it notably compromises sleep quality, especially the NREM and REM phase, vital for memory and mood regulation. Moderating alcohol intake or consuming it well before bedtime could better your sleep odds.

    Engaging in rigorous physical activity late in the evening or succumbing to stress-laden thoughts can keep sleep at bay. The adrenaline surge post an intense workout can push sleep away, while stress can send the mind into an overdrive. Positioning workouts earlier in the day and carving out pre-bed relaxation routines can be beneficial.

    Lastly, the ambiance of your sleep quarters wields considerable influence. Studies emphasize the correlation between optimal room temperature and enhanced sleep quality. Moreover, noise can disturb sleep, impeding its depth and quality. Fine-tuning room temperature and possibly integrating tools like white noise machines can make a tangible difference.

    Better Habits is Better Sleep

    In sum, our day-to-day habits silently script our sleep narrative. Tweaking these can be a step towards improved sleep and, by extension, heightened well-being. For those keen on further sleep enhancement, exploring specialized sleep solutions or engaging with experts can provide tailored recommendations.

    Footnotes:

    [1]: Clark, I., & Landolt, H. P. (2017). Coffee, caffeine, and sleep: A systematic review of epidemiological studies and randomized controlled trials. Sleep Medicine Reviews, 31, 70-78.

    [2]: Gooley, J. J., Chamberlain, K., Smith, K. A., Khalsa, S. B. S., Rajaratnam, S. M. W., Van Reen, E., … & Lockley, S. W. (2011). Exposure to room light before bedtime suppresses melatonin onset and shortens melatonin duration in humans. The Journal of Clinical Endocrinology & Metabolism, 96(3), E463-E472.

    [3]: St-Onge, M. P., Mikic, A., & Pietrolungo, C. E. (2016). Effects of diet on sleep quality. Advances in Nutrition, 7(5), 938-949.

    [4]: Ebrahim, I. O., Shapiro, C. M., Williams, A. J., & Fenwick, P. B. (2013). Alcohol and sleep I: effects on normal sleep. Alcoholism: Clinical and Experimental Research, 37(4), 539-549.

    [5]: Stutz, J., Eiholzer, R., & Spengler, C. M. (2019). Effects of evening exercise on sleep in healthy participants: A systematic review and meta-analysis. Sports Medicine, 49(2), 269-287.

    [6]: Okamoto-Mizuno, K., & Mizuno, K. (2012). Effects of thermal environment on sleep and circadian rhythm. Journal of Physiological Anthropology, 31(1), 1-9.

    [7]: Basner, M., & McGuire, S. (2018). WHO environmental noise guidelines for the European region: A systematic review on environmental noise and effects on sleep. International Journal of Environmental Research and Public Health, 15(3), 519.

    February 6, 2024

  • Doctors’ Group Warns Sleep and Sound Machines May Be Too Loud for Kids

    Original Article | Good Morning America

    The American Academy of Pediatrics is warning parents and caregivers that excessive exposure to loud noises can be detrimental to children, and sound machines can cause more harm to children than previously thought.

    In a statement released Saturday, the AAP said: “What families may not realize is that children are exposed to potentially harmful noise from infancy and that the effects are cumulative over a lifetime.”

    ABC News medical correspondent Dr. Darien Sutton told “Good Morning America” that millions of children are at risk of some form of hearing loss.

    “One of the reasons why is because children have smaller ear canals. That exposes them to intensification of that higher frequency sound and [makes] them at risk for damage,” Sutton explained.

    According to one study published in BMJ Global Health in 2022, more than 1 billion young people are at risk of hearing loss around the world due to unsafe high listening volumes. The AAP cited another study that estimated 60% of adolescents listened to music and audio that was greater than the maximum recommended daily noise intake of 85 decibels averaged over eight hours, a standard that is also for adults and not children.

    “The average volume that kids listen to music at is 70 to 100 [decibels],” Sutton said. “That’s the upper limit of normal or the range for most of our headphone outputs.”

    “Now, noise above 70 [decibels] for prolonged periods of time can cause damage. Noise at 100, which is the maximum, can cause damage in minutes. And noise over 120 can cause immediate harm,” Sutton continued. “So it’s important to pay attention to those volume settings [and] keep them at least 60 to 70% total.”

    With sound machines, often used to lull infants and children to sleep, the AAP warns that they are often too loud for healthy listening.

    “The AAP recommends that parents and caregivers consider that if an environment sounds too loud for an adult, it probably is too loud for a child. ‘Too loud’ can mean having to raise your voice to speak with someone just an arm’s length away,” the pediatricians’ group said.

    “The Academy of Pediatrics recommends, for example, that nurseries have a volume maximum of around 50 decibels,” Sutton said. “That’s a volume that you and I can speak at without raising our voice. Most of these machines go above that. So if you’re going to use them, turn that volume down, place it away from the bed at least seven feet and make sure that you give limits.”

    Signs of hearing loss in children

    • Early speech and language delays
    • No reaction or a startled reaction to loud noises
    • Trouble hearing at schools

    Sutton recommended parents pay attention to their child’s communication.

    “It’s about paying attention to that communication. If you’re finding that your child is speaking loudly, having difficulties with pronunciation, if you’re finding that they’re not reacting to loud noises — these are all some of the reasons why you should get them checked, their hearing checked, because it can help with their learning comprehension and, of course, reduce their risk long-term,” Sutton said.