Snoring is not uncommon among adults. It is more than just an inconvenience to those living with a snorer. Most of us do not realize that snoring may be a symptom of some underlying disorder, and in fact long term snoring can have medical consequences. However, snoring among children is also not uncommon. One in ten children snore every night. It is usually not for the entire night but for short periods now and then while they sleep. But for most parents the concern is a child who suddenly starts snoring loudly throughout the night.
Why do kids snore?
Children snore for the same reason that adults snore. The sound is created when tissue in the mouth and throat vibrate. Normally these tissues are kept firm by muscles. During sleep these muscles relax and the tissues become flexible. In some people the muscles relax too much and this can allow the tissues to become lax to the point that it partially obstructs the airways. The flow of air during breathing then causes these tissues to vibrate. The sound produced can vary depending on which tissues vibrate more.
There are other factors involved in snoring. Sometimes the obstruction of the airways is further compounded by nasal congestion, an inflamed throat and tonsil, structural abnormalities in the mouth and throat, and with higher fat content in the airway tissues. Snoring should not be ignored if it is persisting for long periods of time. It can affect a child’s physical and mental health over time, contribute to behavioral problems and affect academic performance.
If your child has only started snoring over the past few days or weeks then there is usually no need to be concerned about long term complications. The underlying cause still needs to be treated but more often than not the cause is acute in nature and will clear up on its own or with the proper medical treatment.
Causes of Snoring in Children
Here are some of the common causes of snoring in children. Sometimes these conditions are not obvious and snoring may be one of the few symptoms present. It is therefore important that a child who snores is assessed by a pediatrician and otorhinolaryngologist (ENT specialist).
Rhinitis is one of the major causes of snoring in children. It is a result of inflammation of the nasal passages due to allergies to one or more substances (allergen). With perennial rhinitis, the nasal congestion and snoring may persist throughout the year or arise when the condition worsens. Seasonal allergic rhinitis worsens at specific times in the year and therefore snoring is more likely to occur during certain seasons.
Infections of the nose, throat and airways are another common cause of snoring in children. The common cold, flu, tonsillitis and sinusitis cause some degree of airway obstruction. Children are particularly prone to viral infections of the airways, especially if they have a history of allergies affect the upper respiratory tract.
Some medication that can make a child drowsy, particularly if it has alcohol, will also lead to snoring. It may cause the muscles of the throat tissue to relax beyond the normal degree. Fortunately most kid’s medication do not have alcohol and other substances that may cause significant sedation.
A deviated septum is not very common. It is when the bone separating the two nostrils is crooked. Although most people think that it is a cosmetic problem rather than medical issue, a deviated septum can restrict air flow. Surgical intervention to correct a deviated septum can therefore improve breathing.
Overweight and obese children are at risk of snoring. It is a widespread problem that has not been highlighted in the current child obesity epidemic affecting most developed nations. The problem is more likely to progress and complicate over time, and overweight or obese children are at a greater risk of obstructive sleep apnea.
Signs and Symptoms
Although snoring is often seen as a condition on its own, it is actually a sign of airway obstruction. The restriction of air flow is not without consequences. In mild cases, usually where the snoring is very mild or sometimes even absent, additional symptoms of this restricted air flow is not significant. However, in severe and long term cases, snoring may be accompanied by these other symptoms.
- Morning headache
- Waking up feeling tired (morning fatigue)
- Sore throat worse in the morning
- Nasal tone to the voice
- Sleepy during the day
- Difficulty concentrating
- Poor memory
- Behavioral and academic problems
- Irritable and anxious
However, these symptoms may not be as obvious at the outset. Sometimes snoring is the only indication that there is an underlying obstruction with air flow while sleeping. So when is snoring a problem in children?
- If the child snores loudly.
- If there is gasping for air or snorting while sleeping.
- If a child awakens and is panting.
- If the child is restless while sleeping.
- If the child sleeps in awkward and abnormal positions.
- If the child has uncharacteristic difficulty awaking in the morning.
- If the child tends to sweat excessively while sleeping.
Treatment of Child Snoring
The treatment of snoring in children has to be directed at the underlying cause. Allergies may be treated with antihistamines, bacterial infections with antibiotics and so on. There are a number of anti-snoring devices on the market but not all may be suitable for children. When enlarged tonsils and adenoids or a deviated septum are a problem then surgery may become necessary. Dietary and lifestyle measures may help when body weight problems are the cause of snoring. C-PAP machines are not usually considered for children but may be used when other measures fail and the restriction in air flow while sleeping is severe, like obstructive sleep apnea.
Not all snoring needs to be immediately treated in children. Sometimes a wait and watch approach may be useful as snoring may resolve on its own once the underlying condition subsides. A medical assessment is always advisable to identify serious health problems as soon as possible. A sleep study may even need to be considered if the doctor considers it necessary. The link between snoring, behavioral problems and poor academic performance should always be isolated before conditions like attention-deficit hyperactivity (ADHD) disorder is treated in children.