Snoring in Kids

Published on: June 15, 2019

Many of us have had a good night’s sleep interrupted by a partner or spouse who snores. But what if the loud, gurgling sounds at night actually turn out to be coming from your precious child. We take an in-depth look at the health implications of snoring in children, and what to do if your child snores, from a pediatric ENT specialist’s point of view.

By Assist. Prof. Dr. Dhave Setabutr 

Snoring is one clinical entity along a spectrum of diagnosis of what physicians refer to as sleep-disordered breathing (SDB). It could be simple snoring, or it could be something a little bit more worrisome.

In simple words, at night our breathing patterns differ from when we are awake because our body is in a relaxed state. Moments of obstruction in our airways can arise, which results in disordered breathing such as snoring. It is the stuttering sound that keeps bed partners awake. But in some cases, it could be more concerning, and that is known as obstructive sleep apnea (OSA).

Obstructive Sleep Apnea in Children

Obstructive sleep apnea can occur in children, and with relative frequency. Like their adult counterparts, various issues can cause OSA in children. However, the most common sources are the tonsils and the adenoids. Adenotonsillectomy, or removal of the adenoid and tonsillar tissue, is one of the most common surgical procedures performed on children in the United States. Sleep-disordered breathing is the main indication for doing so.

Children with sleep-disordered breathing usually suffer from symptoms related to breathing difficulty during sleep. Many parents describe their child as having breathing pauses at night and intermittent gasping for breath. Some children are described as mouth breathers children who do so can sometimes be identified by having dry lips as they keep their mouth open during the night.

Apart from breathing abnormalities, there are other signs parents can be on the lookout for. Although we all know that bed wetting is common in certain age groups, children with OSA can have more episodes than their counterparts without OSA.

In terms of daytime symptoms, children can be relatively hyperactive and some may carry a diagnosis of attention deficit hyperactivity disorder (ADHD). This is in stark contrast to adults with OSA, as that patient population typically complain of significant daytime sleepiness.

Tonsils and Adenoids

Tonsils and adenoids are lymphoid tissues and they have a key role in warding off infections. But as we grow older, this role lessens. The tonsils, which many of us have seen at the back of our mouth, can enlarge and shrink depending on inflammation (i.e. having a cold or tonsillitis). Many parents will state that their child’s breathing at night can sometimes worsen when they are sick due to the enlargement of the tonsils as the main reason.

The adenoids lie in the back of the nasal cavity. We all have one adenoid pad at the central back part of the nose. These adenoids too can grow and obstruct the nasal airway just as the tonsils can, causing patients to feel like they have a blocked nose or have a tendency to snore when sleeping.

Should I get it checked out?

If such symptoms occur, it is important to contact your physician to evaluate whether or not there is a need for treatment. Sometimes allergies can play a role and adequate medical treatment of allergic rhinitis can improve symptoms.

In other instances, surgical management may be more appropriate. This can sometimes include removing the tonsils or adenoids, or both. It is important to consult a surgeon to decide if that is a reasonable option. 

In some cases, a sleep test, or polysomnogram (PSG), may give both the parent and physician some insight into what is truly going on while the child is sleeping, and it is called the gold standard in diagnosing OSA. The results can tell parents if the child stops breathing at night or if he/she has any issues with oxygen levels that drop and can give parents more information before proceeding with the best treatment plan.

Snoring, for the most part, is what we’re all familiar with, that loud rattling sound that can keep your bedmate up at night. In some instances, it may indicate something that could have an easy treatment plan to help you and your child achieve better sleep and better energy. 

Photo by Annie Spratt on Unsplash.

About the Author

Assist. Prof. Dr. Dhave Setabutr is a U.S. board-certified specialist in Otolaryngology and  Pediatric Otolaryngology (Ear, Nose, Throat) at Bumrungrad International Hospital.

The views expressed in the articles in this magazine are not necessarily those of BAMBI committee members and we assume no responsibility for them or their effects.

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