An ENT answers parents’ common questions regarding childhood snoring.
Whenever I ask a family about their child’s sleep habits, I include questions about the noises their child makes during sleep. Even in children without sleep concerns, moms and dads frequently note snoring in kids “if they’re really worn out.” In fact, most of us associate snoring with good hard sleep. However, whether it’s “purring,” “sawing logs,” or “sounding like a bear,” a child who snores deserves a closer look — er, listen.
What is snoring?
Snoring is a sound created when partial airflow obstruction occurs while taking a breath. Try to imitate someone snoring, and you’ll see that you have to block up your airway in the back of your throat to make that typical sound. Most snoring relates to airflow reduction behind the soft palate, across the uvula, or along the back of the tongue. The noise produced is coarse and growly because the tissue creating the sound is vibrating in the airway in a bulky and erratic fashion.
Is it normal for a child to snore?
Technically, no, but snoring is extremely common. Whether it’s due to a touch of allergies, a common cold, poor positioning (as in a car seat), or the sedative effects of certain medicines (like those found in over-the-counter allergy remedies), most people snore from time to time. Children are no exception.
Should I worry that my child snores often?
It depends. Through sophisticated sleep studies, questionnaires, IQ tests and the like, research shows that even primary snoring (without any other signs of sleep apnea) may degrade sleep quality enough to affect daytime learning. Despite this information, many clinicians and surgeons may be reluctant to recommend medications or surgery for snoring alone, pointing to risks or side effects of treatment that may outweigh the possible benefits.
When snoring is accompanied by episodes of gasping for air or obstructive pauses in airflow, other body systems start to suffer. Nighttime signs to watch out for also include extremely restless sleep with significant tossing and turning, sleepwalking, talking out during sleep, tooth-grinding and/or jaw clenching, and bed-wetting (in a potty-trained child).
During the day, symptoms of concerning sleep-disordered breathing can vary. Most children are reluctant to admit that they are tired. Hyperactivity, inattention, moodiness or aggression may all be signs of poor sleep. Other children may “keep it together” during school only to fall asleep on the car ride home. On the other end of the behavioral spectrum, some kids with sleep-disordered breathing are difficult to wake in the morning and may remain groggy throughout the day. Headaches are not uncommon. Mouth breathing during the day certainly signifies a high risk for sleep-disordered breathing at night.
In the end, a doctor or other healthcare provider should look into these nighttime or daytime symptoms in a child who snores. Sometimes a detailed history and physical exam provide enough clues to diagnose and treat the underlying cause of snoring, while other children may require a sleep study or investigation by a specialist. Kids with severe disease may require an operation to relieve sleep-disordered breathing, and for those children, removal of the tonsils and/or adenoids is often a first-line therapy.
Christopher Wootten, M.D., is Director of Pediatric Otolaryngology at Vanderbilt University Medical Center and a member of Vanderbilt’s Complex AeroDigestive Evaluation Team (CADET). The team brings together specialists from across the medical center to diagnose and develop treatment plans for conditions including voice box, windpipe, pulmonary, upper digestive tract, sleep and feeding disorders.