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Snoring in children: Could it be a sign of a bigger problem?

Quality sleep is essential for a child’s development, so it’s important that children get a solid amount of sleep every night without distractions like snoring. Yes, children can snore too — in fact, about 27% of kids snore when they sleep. If it only happens once in a while with no impact on the child’s overall health, snoring in children is usually of not much concern. But if the snoring is frequent and severe, it may be a sign of disturbed breathing from underlying issues.

Knowing more about the types and causes of snoring in children can help parents decide when to seek medical attention, which could go a long way.

Is snoring the same for all children?

Not all snoring is the same. In children, the frequency and severity matters greatly. Mild snoring, also known as primary snoring, is simple and habitual. It occurs roughly more than twice a week with no other noticeable symptoms or health issues. About 10-12% of children have primary snoring.

What we should be concerned about is obstructive sleep apnea (OSA), a condition that indicates the presence of sleep disordered breathing. With OSA, the child’s airway becomes blocked multiple times throughout the night, causing lapses or apneas in his breath. Although the child is sleeping, OSA can greatly affect quality of sleep and is known to have negative impacts on his physical and mental health and behaviour.

Studies estimate that about 1.2-5.7% of children suffer from OSA. Of those, a staggering 70% receive an initial diagnosis of primary snoring. This lapse in error is attributed to a lack of accuracy; parents may not always be aware of their child’s frequency and severity in snoring. On top of that, detailed and comprehensive testing for sleep apnea, known as a polysomnography, may not be practical for all children.

What causes children to snore?

Snoring occurs when air cannot move freely through the nose and throat. As such, when a person inhales or exhales during sleep, tissue around the airway at the back of the throat vibrates, creating noise. Multiple factors can cause blockages of the airway. In children, the most common risk factors are:

Large and swollen tonsils or adenoids

Our tonsils and adenoids are located around the back of the throat. If they are large or swollen due to infection, they can obstruct the airway and cause snoring. Large and/or swollen tonsils and adenoids are the most common cause of sleep disordered breathing in children.

Obesity

Studies show that children who are obese or overweight are more likely to snore. This is because being obese can narrow the airway and increase the risk of sleep disordered breathing like OSA.

Asthma

Asthma may affect normal breathing. If it causes blockages of the airway during sleep, it can provoke snoring.

Congestion and allergies

Congestion from the flu or cold-like symptoms can block the flow of air in the airway, and an infection may further inflame the tonsils and adenoids. Similarly, when allergy flare ups cause inflammation in the nose and throat, this will make it harder to breathe which increases the risk of snoring.

Facial anatomy

Some people may just be born with a facial anatomy that makes it harder for them to breathe when sleeping, such as a deviated nasal septum, where the nasal septum is displaced to one side. A deviated nasal septum can also be caused from injury from high contact sports.

Secondhand smoke/contaminated air

Exposure to secondhand smoke can affect breathing and has been linked to a higher risk of snoring in children. Likewise, low quality or contaminated air can affect normal breathing and lead to snoring.

The danger of childhood snoring

Snoring in children once in a while isn’t usually anything to be worried about, but regular or severe snoring that hints at sleep-disordered breathing can carry health consequences. Obstructive sleep apnea in particular is of the greatest concern as it has been linked to impaired brain development, poor grades, high blood pressure and behavioural problems in children. Even if the snoring isn’t as severe as OSA, recent studies show that habitual snoring poses the same health risks.

Parents with children who snore should take note of the following signs that indicate a bigger problem might be at hand:

  • Snoring three times or more a week
  • Gasp-like pauses or difficulty breathing while sleeping
  • Feeling sleepy in the day
  • Headaches in the morning
  • Bedwetting
  • Difficulty concentrating in school
  • Obesity

While these factors are indicators of sleep-disordered breathing, not all children who snore and have the above issues have the condition. My advice is to see a paediatrician or ENT specialist to explore diagnosis and treatment options.

At home, I suggest also taking steps to help your child sleep better. This could be through setting a consistent sleep schedule, limiting screen time before bed and creating a bedroom as comfy as possible.

References

  1. Smith, D. L., Gozal, D., Hunter, S. J., & Kheirandish-Gozal, L. (2017). Frequency of snoring, rather than apnea-hypopnea index, predicts both cognitive and behavioral problems in young children. Sleep medicine, 34, 170–178. https://doi.org/10.1016/j.sleep.2017.02.028
  2. Hagström, K., Saarenpää-Heikkilä, O., Himanen, S. L., Lampinlampi, A. M., & Rantanen, K. (2020). Neurobehavioral Outcomes in School-Aged Children with Primary Snoring. Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists, 35(4), 401–412. https://doi.org/10.1093/arclin/acz053
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