Whether it’s the gentle purr of your toddler or wall-shaking snoring of your teenager, snoring can be a source of concern for any parent. Recent research has shown that sleep is important in brain development, learning, staying healthy and maintaining attention. Snoring can be a clue that your child is not getting good quality sleep.
If your child is snoring, there may be treatments to help address the problem. The most common reasons for snoring in children are enlarged tonsils and adenoids. Children with nasal blockage related to chronic allergies, a deviated septum or narrowing of the nose from birth might also experience similar problems.
A careful examination of the nose, mouth and throat can reveal the source(s) of potential blockage. Your pediatrician might also recommend additional testing during the office visit or in a specialist’s setting to determine the amount of blockage and if surgery would help improve your child’s sleep.
Here are a few things to watch out for to determine if you should be concerned about your child’s snoring.
Nighttime
Louder snoring has been shown to be associated with sleep disturbance, so if your child has ‘grown-up’ snoring, you may want to talk to their doctor.
Long pauses in between breaths (longer than 2 normal breaths) and choking or gasping for air after these pauses could mean that the airway is collapsing and preventing the flow of air on and off throughout the night. This is known as obstructive sleep apnea and is the most severe form of sleep disturbance. Sometimes these episodes of airway blockage can jar children from the deep stages of sleep into lighter stages of sleep or to the point of waking up.
Frequent awakening at nightcombined with snoring could also be a sign of sleep-disordered breathing. If rapid, frequent transitions to lighter stages of sleep occur, this could also contribute to bedwetting. Of course, there are many other possible reasons for bedwetting, but if it occurs with frequent snoring, talk to your child’s pediatrician about the possibility of sleep apnea.
Mouth breathing throughout the night could mean that the nose is being blocked by enlarged adenoids or nasal tissues, forcing your child to breathe through their mouth instead.
Children who are very restless and toss and turn throughout the night may have restless leg syndrome or airway blockage that is leading to restlessness. Though there are normal movements during sleep (called periodic limb movements of sleep), being restless at night can also be a symptom of poor sleep quality.
Sleep walking and sleep talking associated with snoring may be a cause for concern and would be worthwhile to discuss with a doctor. Interestingly, night terrors – periods when your child is asleep but seems awake and is not responsive to you, but appears frightened or screaming - are NOT associated with sleep-disordered breathing and indicate that your child is in a deep stage of sleep.
Recently, there has some concern raised about tongue tie and the potential for a tethered tongue to increase snoring or sleep apnea in children. There is no clear association between tongue tie and sleep apnea and division of tongue tie is not recommended for the management of snoring or sleep apnea.
Daytime
If snoring is contributing to poor sleep quality, this may be seen in your child’s behavior during the day.
Children who are difficult to wake up or do not feel refreshed upon awakening, may not be sleeping well. Older children may report that they feel like they didn’t get a good night’s sleep as well.
If a child falls asleep easily during the day, frequently in class, on short car trips or is generally tired or fatigued throughout the day, this could mean they are not getting enough quality sleep at night. These symptoms can be related to other medical conditions or shortened sleep time as well, so it is important to talk to your child’s doctor about other possible medical conditions and ensure your child is getting enough opportunity for sleep.
Children may become impulsive and inattentive. Researchers think this is related to a ‘filter’ in the brain that helps to stifle impulses and maintain attention. When the brain is not adequately rested, the ‘filter’ doesn’t work as well. Sometimes, these symptoms can be mistaken for ADHD, so if your child is inattentive and impulsive, keeping an eye on their sleep quality and an ear out for snoring is helpful.
Patrick Walz, MD, is a member of the Department of Otolaryngology at Nationwide Children’s Hospital and is an assistant professor of Otolaryngology – Head and Neck Surgery at The Ohio State University College of Medicine.
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