Snoring in children: When should you be concerned?

What does it mean to snore?

Pediatric sleep-disordered breathing (SDB) is a general term for breathing difficulties during sleep. Snoring is a noise caused by vibration of the uvula and soft palate in the back of the throat.

The loudness is determined by how much air is passing through, vibration of the throat tissue, and collapse or relaxation of this tissue during sleep. Children 3 years or older tend to snore during the deeper stages of sleep.

Approximately 10% of children snore regularly, 25-40% of children have SDB and about 2-4% of children experience obstructive sleep apnea (OSA) – which is when a person stops breathing for 10 or more seconds during sleep.

When should you be concerned?

When your child sleeps, their body rests and restores its energy level impacting both physical and mental well-being. Loud snoring becomes a medical concern when it is associated with abnormal breathing and interrupts sleep. If your child is not getting enough sleep because of SBD, this may lead to:

• Hyperactivity or feeling tired during the day
• Behavioral problems
• Learning difficulties/poor school performance
• Growth retardation
• Obesity
• High blood pressure

Children with SDB tend to snore and exhibit repeated episodes of under breathing (hypopnea) and/or complete pauses in breathing (apnea) during sleep. Parents may witness gasping or snorting, restless sleep, frequent night time awakenings, teeth grinding, bed wetting and unusual sleep positions.

What should you do?

If you are concerned your child is not sleeping well, follow up with your pediatrician to see if a sleep study or ENT referral is needed.

If your pediatrician refers your child to an Otolaryngologist (ENT doctor), the specialist will evaluate the structures of your child’s airway for abnormalities, like enlarged tonsils or adenoids. Depending on the severity of the snoring and anatomy findings, your child may need a sleep study to evaluate for sleep apnea.  

A sleep study will determine the degree of obstruction. If the study shows OSA and enlarged tonsils or adenoids, your doctor may suggest removing the tonsils and adenoids. This surgical procedure typically improves sleep obstruction.

Schedule an Otolaryngology appointment online.

Nonsurgical intervention with positive pressure ventilation is also a treatment option for OSA.

Obesity is a risk factor for sleep obstruction. Weight loss, in addition to other therapies, in overweight or obese children can help improve sleep.  

Outdoor and indoor allergies can also cause nasal congestion and mouth breathing impacting sleep in children. Make sure your child receives proper medication for allergies and see an allergist if needed.

Overall prognosis and outcomes

Once your child receives appropriate treatment, their behavior, performance and development typically will improve. About 20% of children may continue to have sleep concerns after surgery and a sleep study is recommended in such cases.