When snoring in children and toddlers is cause for concern
While some snoring in children and toddlers is normal, sometimes it's a sign of a medical condition that needs treatment, and they should see their pediatrician, who may refer them to a pediatric otolaryngology (ENT) specialist.
“Approximately 10% to 20% of kids may snore. Snoring is a sign of disturbed airflow from the nose and mouth to the lungs. If there is something getting in the way of the air moving, then your child snores,” said Dr. Taher Valika, Lurie Children's Division of Otorhinolaryngology - Head and Neck Surgery.
Typical snoring could be described as audible breathing, and this may occur on and off throughout a night of sleep depending on the stage of sleep the child is in (light sleep, deep sleep or dream sleep). It can also depend on the sleep position of the child.
Light snoring is common in children and may not require medical intervention. Snoring may relate to position while sleeping. A child may be more likely to snore when lying on his or her back than on a side or stomach. It could also have to do with the level of congestion present from upper respiratory tract infections (colds) or allergies, or a number of anatomic variables. This type of snoring is considered “primary snoring.”
“Still, there are more severe cases when interventions might be required to open the upper airways, such as surgically removing the tonsils and/or adenoids,” said Dr. Kathleen Billings, also a physician in Lurie Children's Division of Otorhinolaryngology - Head and Neck Surgery.
Worrisome snoring is loud enough to hear down a hallway and may be associated with gasping, more labored breathing and what we call apnea pauses. It is not expected that a family member should recognize an apnea pause, but persistent, loud snoring is usually a good sign to the parent that the child should be assessed by their primary care provider.
In the most severe cases of snoring, kids may have sleep apnea (pauses in breathing). The consequences of sleep apnea in children include hyperactivity, impaired attention, behavior problems and reduced IQ, so accurate and timely diagnosis is vital to allow early intervention and improved outcomes. Pediatric otolaryngology specialists can correctly diagnose and treat children with snoring issues.
“Other symptoms to look for include gasping for breath, choking during sleep, restless sleep, nightmares, night terrors or bed-wetting,” Valika said. “Many kids may have symptoms during the daytime as well including waking up tired or daytime sleepiness requiring a nap, mouth breathing, or changes in behavior (hyperactivity or aggressive behavior).”
The most common anatomical reason for snoring is enlargement of tonsils and adenoids, but factors such has obesity and other diseases can increase the risk as well. “Other anatomic issues besides enlargement of the adenoids and/or tonsils include deviation of the septum, a narrow palate, small jaw and narrowing of the larynx (voice box). A pediatric otolaryngologist can help your family determine exactly what condition is affecting your child,” said Dr. Saied Ghadersohi, Otorhinolaryngology - Head and Neck Surgery.
If the child demonstrates loud, persistent snoring night to night, with associated symptoms such as mouth breathing, witnessed apnea pauses, restlessness, gasping, difficulty waking in the morning and daytime fatigue, they may benefit from a specialty evaluation with a pediatric otolaryngologist to help you determine the best individualized plan for your child.
Learn more about or make an appointment with Lurie Children's Division of Otolaryngology at www.luriechildrens.org/en/specialties-conditions/pediatric-ent-otolaryngology.
• Children's health is a continuing series. This week's article is courtesy of Ann & Robert H. Lurie Children's Hospital of Chicago. For more information, visit www.LurieChildrens.org.