Snoring in Children - Causes and Problems

It is common for most people, even children, to snore occasionally. Excessive snoring, however, will prevent restful sleep and can disrupt the child's daytime activities.

A child's gentle snore can mean a peaceful sleep, but there may be a problem when it becomes loud and constant. Snoring in children can lead to all sorts of issues, including interrupted breathing at night which may lead to behavioral or emotional problems during the day such as irritability or lack of concentration.

It is important that parents recognize the signs their child has excessive snoring, so they know how best to help them get better quality sleep without disrupting their daily life too much.

While snoring doesn't necessarily mean there is a serious underlying problem, it could be a manifestation of sleep-disordered breathing, and can potentially contribute to other problems such as night tremors.

Related: Children & Sleep Disorders

Should I be concerned if my child snores frequently?

Most people are familiar with the snoring noise, but maybe not the underlying causes. Snoring is usually caused by the airway at the back of the throat being blocked. Air trying to pass through the obstruction causes the structures to vibrate enough to produce sound. Generally speaking, the more air that's passing through, the more vibration is produced, resulting in louder snoring.

There are many potential causes for children's snoring, such as enlarged tonsils or adenoids, allergies, or asthma. However, if the snoring keeps on getting louder and more consistent every other night, it might be indicative of a sleep disorder.

"Sleep-disordered breathing ranges in seriousness."

Most of the time, light and occasional snoring ( also known as simple snoring or habitual snoring) in children is not associated with health issues, so it's nothing to worry about.

If a child has more serious cases of sleep-disordered breathing, they may develop obstructive superficial apnea (OSA). This is characterized by frequent breathing lapses during the night. These lapses (also called apneas) could range from a few seconds to several minutes in length when the child's nasal passages become blocked. The lapses can occur dozens of times per night, affecting normal breathing and causing fragmented sleep. This reduces the sleep quality and could negatively impact the child's physical health, mental health, learning, and behavior.

How Common Is Snoring in Children?

It's thought that about ten percent of children snore excessively, and of those, two to three percent may have a condition called sleep apnea. This occurs when muscles relax so much that the airway is blocked enough to restrict airflow for a period of time. When this happens, the brain signals the body to start breathing again, often resulting in gasping and choking. This disrupts restful sleep and can lead to other medical conditions that could be serious.

Studies suggest that about 1 to 5% of children with sleep apnea are mostly aged between 2-8 years. 70% of kids diagnosed with sleep-disordered breathing initially received a diagnosis of primary snoring.

Snoring and obstructive sleep apnea (OSA)

Snoring is often associated with obstructive sleep apnea. However, not all children who snore have obstructive sleep apnea. Obstructive sleep apnea is a more serious condition where the child's airway becomes completely blocked during sleep, preventing them from breathing correctly.

If the following symptoms accompany your child's snoring, it may be an indication of OSA, and you should seek professional help for further evaluation:

• Breathing pauses, choking, or gasping during sleep. This could indicate that the airway is blocking, thus preventing the natural flow of air on and off throughout the night.
• Thrashing or moving around in bed. If your child thrashes around in bed, this could signify that they are struggling to get comfortable. This may be due to obstructive sleep apnea or restless leg syndrome (a condition where the legs feel creepy and uncomfortable during sleep)
• Frequent nighttime awakenings. Sleep lapses prevent children from getting into the deep stages of sleep needed for proper rest. Children who are not getting adequate sleep at night may seem sleepy or hyperactive during the day due to lack of enough deep sleep and/or restful, quality sleep.
• Behavioral problems. Aggressive behavior, difficulties in school, and poor academic performance has been linked with sleep deprivation.
• Mouth breathing. If your child is frequently breathing through the mouth when sleeping, it could mean enlarged adenoids or nasal tissues are blocking the nasal passage.

The best way to determine if your child is experiencing any of these symptoms is by keeping a detailed child's sleep diary for at least one week. If you notice that your child has several of the above symptoms, it would be worthwhile to bring this up with their pediatrician.

Diagnosing sleep-disordered breathing in children is challenging because it requires a night of Polysomnography (PSG) which involves monitoring brain waves, heart rate and rhythm, respiratory effort, and oxygen levels in the blood. The PSG (sleep study) test must be done at an accredited sleep center where qualified professionals can interpret the results.

Snoring and Children; Causes Of Snoring

Snoring occurs when the airway is blocked or narrowed and makes it for air to flow freely through the airway. Since air can't pass freely to the back of the throat, the soft palate tissue around the upper airway is forced to vibrate as the child inhales or exhales, creating an audible noise.

There are several factors that can create blockages of the airway and cause snoring in children. Some of the most common causes include:

• Enlarged tonsils or adenoids. The tonsils are located on each side of the throat and are made of lymph tissue. They sit just behind the nose and above the roof of the mouth. If they become enlarged, they can block the airway and cause snoring.
• Allergies or sinus infections. If your child has allergies or a sinus infection, the nasal passages can become inflamed and congested. This will block the airway and cause snoring.
• Obesity. Studies have shown that children who are overweight are more likely to snore. This is because excess weight around the neck can put pressure on the airway and cause it to become narrow, increasing the risk of snoring and sleep apnea.
• Contaminated air. Environmental factors such as second-hand smoke, air pollution, and excess contaminants can affect normal respiration by causing nasal congestion. This may affect the child's breathing increases the risk of snoring.
• Anatomic characteristics. Some children are born with anatomic traits that make it difficult to breathe regularly. For instance, a deviated septum in which the nostrils are not equally separated can obstruct the nasal passages and lead to snoring.
• Sleep position. Snoring is more common in children who sleep on their backs. When they are sleeping on their back, the tongue can relax and fall to the back of the throat, which can partially or completely block the airway.

What Can Help Reduce Snoring in Children?

Most children who experience light snoring will eventually outgrow the habit. Even if your child has been diagnosed with frequent snoring or regular sleep-disorder breathing, they can still stop snoring by following the right treatment plan.

The first step to reducing snoring is to talk to a paediatrician.

The doctor may do a physical exam and ask questions about your child's health, sleep habits, and symptoms. Sometimes the paediatrician might refer you to an ENT (ear nose throat) physician or a sleep specialist to rule out any serious medical conditions affecting normal breathing.

Once there is confirmation of snoring as the root cause of sleep-disordered breathing, the doctor will create a treatment plan that may include:

Reducing or eliminating allergens.

If your child is allergic to certain foods and environmental triggers such as air pollutants, dust, and pollen, they should avoid them at all costs.

Treating sinus infections or allergies.

Your child's pediatrician can prescribe medications to treat sinus infections and allergies. They may also recommend over-the-counter antihistamines to reduce or eliminate the symptoms.

Weight loss program.

If your child is overweight, their pediatrician can create a weight loss plan to help them lose excess fat around the neck and free up space in the airway that will prevent snoring.

Correction of anatomic abnormalities.

If your child has a deviated septum, surgery may be recommended to correct the problem and improve airflow. Adenotonsillectomy, a procedure to remove swollen tonsils and adenoid tissues, is also one of the most common treatments recommended for children with severe sleep apnea and light snoring (sometimes).

Changing sleep position.

In some cases, changing the child's sleep position can help reduce snoring. For instance, if they are used to sleeping on their back, try putting them on their side, stomach, or even propping them up with a few pillows to keep the airway open.

Nasal strips or mouth guards

You can purchase over-the-counter nasal strips and mouth guards to help keep the child's airway open. Your child's doctor may also prescribe a custom-made oral appliance if your child's snoring is severe.

Continuous positive airway pressure (CPAP).

If all other treatments have failed, a pediatrician may recommend a CPAP (continuous positive airway pressure) machine to treat more severe cases of snoring & sleep apnea.

Sleep hygiene.

Ensuring your child has a good bedtime routine and better sleep quality is crucial in preventing snoring. Establishing regular sleeping hours, avoiding exciting activities right before bed, and having a dark and quiet room to sleep in will help improve the quality of your child's slumber.

Bottom Line

While sometimes thought to be amusing and even cute, snoring in children, especially loud snoring that happens frequently, can have some consequences. If snoring is causing your child to wake in the middle of the night, or if you see some signs that may indicate excessive tiredness, it's a good idea to mention child snoring to your pediatrician. There are ways to treat this condition to help stop snoring, but an accurate diagnosis should be the first step. Restful sleep is essential for good health.