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Signs That Indicate Your Child's Snoring Is a Problem Written By: Dr. Ankita Shah, January 2022

Tongue Tie

For children, sleep is essential for their overall physical, cognitive, emotional, and behavioural development. When a child snores, it is a cause of concern for parents as it can affect their quality of sleep. More importantly, sleeping with an open mouth or snoring at any age is not normal, and in children, it could lead to paediatric sleep-disordered breathing (SDB). Mouth breathing during sleep is one of the early signs of SDB, which could progress to snoring and sleep apnea.

Below are some statistics that’ll help you understand how common snoring is in children. Also listed are a few signs of snoring in children along with effective treatment for the same.

A] How Common is Snoring in Children?

According to statistics, it is estimated that 60-70% of children suffer from mouth breathing. Whereas, 30% of children aged 2-6 years and 50% of children diagnosed with ADHD actually suffer from sleep disorders.

Studies also estimate that 1.2-5.7% of kids have obstructive sleep apnea (OSA). Whereas, for children diagnosed with SDB, approx. 70% of them also receive a diagnosis of primary snoring.

How do you know if your child has disturbed sleep from snoring?

Some of the common signs of unhealthy sleeping patterns in children are:

Continuous tossing and turning in bed

Frequent cold, cough and allergies

Sleeping like a frog or with an extended neck

Thumb sucking or sucking on other objects

The child is underweight or short for his age

The child is diagnosed with tonsils and adenoids

The child clenches or grinds his/her teeth

B] Causes of Snoring in Children

Apart from affecting the regular growth and development of the child, restriction of airflow (that causes snoring) could impact the child’s mood and behaviour. It could lead to learning issues, ADHD-like symptoms, insulin resistance, and obesity. If snoring is not treated at an early stage, there is a high risk of acquiring sleep apnea in adulthood, which could lead to thyroid, diabetes, blood pressure, etc. Mentioned below are a few causes of snoring in children.

Enlarged or swollen tonsils & adenoids: This is one of the common causes of snoring in children. Both tonsils and adenoids are tiny tissues. Tonsils are found at the back of the mouth on both sides of the throat, while adenoids are located behind the nose. If any of these tissues become naturally large or swollen due to infection, it may lead to obstruction of the airway that can cause snoring.

Obesity: Overweight children are more prone to snoring as obesity can narrow the airway, increasing the risk of SDB, especially obstructive sleep apnea (OSA).

Nasal Congestion: Nasal congestion can block the smooth airflow, while an infection may inflame the tonsils and adenoids.

Allergies: Allergies are known to increase the risk of inflammation in the nose and throat. This could make breathing difficult for the child, increasing the risk of snoring.

Asthma: Asthma can cause partial airway blockage, which may affect normal breathing resulting in snoring.

Tongue tie: Tongue tie in children prevents the tongue from resting in the roof of the mouth, hampering breathing, jaw growth, eating, drinking, posture, among others. If left untreated, tongue ties can cause loud snoring in children. Here, correction of tongue function and mobility can help improve nasal breathing and open up the airway passage.

Poor muscle tone: Poor muscle tone in the face, throat and tongue could interfere with the airflow as the muscles become too relaxed, collapsing into the airway.

Backwardly positioned lower jaw: Snoring in children can also be caused due to the lower jaw dropping backwards during sleep, due to a narrow upper jaw or the lack of muscle strength. When the jaw falls back, the tongue falls back too, blocking the airway. Snoring is the hoarse or harsh sound that occurs when air flows past the blocked tissues in your throat, causing the tissues to vibrate as you breathe.

Narrow upper jaw: Likewise, if a child’s upper jaw is narrow, it can cause a deviated septum in the nose and also restrict the lower jaw to grow forward thereby causing breathing issues that could lead to snoring.

Lack of tongue space: Narrow and receding jaws could lead to insufficient tongue space in the mouth leading to airway obstruction, impeding the airflow.

C] Signs That Indicate Snoring is a Problem in Children

If you are worried about your child’s snoring, visit an airway focused paediatric dentist at the earliest. While snoring may be common, the below signs of snoring in children could indicate the possibility of sleep-disordered breathing.

Mouth Breathing: As a sleep-disordered breathing, habitual mouth breathing can have a negative impact on your child’s health. Inhaling and exhaling through the nose with your mouth closed is a healthy way of breathing. But, if the nose is not functioning, it disturbs the balance between the nose and the oral cavity. This could slowly progress to noisy breathing, snoring, and eventually sleep apnea. Sleep apnea could lead to partial or complete obstruction of the respiratory tract.

Frequent night-time sweating: This is triggered by low oxygen and closed airway that leads the sympathetic (fight or flight) nervous system into over-activity during sleep resulting in night-time sweating.

Unusual positions while asleep: For children diagnosed with sleep apnea, a hyperactive extension of the neck is common as it helps open the airway.

Chronic bed-wetting: Several studies indicate that children with sleep apnea are more prone to bed-wetting.

Morning headaches: This is caused due teeth clenching and grinding and lowered oxygen and high blood pressure during sleep.

Hyperactivity and inattentiveness in school: Children with sleep apnea are often misdiagnosed with ADHD. By talking to a paediatrician about your child’s sleeping habits and snoring, you could prevent your children from unnecessarily using medications for ADHD.

Other signs of snoring in children include:

Frequent sleepwalking and night terrors

Learning difficulties

Frequent tossing and turning in bed

Clenching and grinding of teeth

Diagnosed as ADHD

Frequent cold, cough and allergies

Delayed growth and/or doesn’t match the ideal height and weight for the age

Moody or bullying behaviour, Irritability

D] Types of Treatment Available For Snoring

Since we follow a multidisciplinary holistic approach, we use a combination of treatments to treat paediatric SDB. These include:

Oral Myofunctional Therapy

Airway Orthodontics

Breath Retraining

Habit Correction

Correction of Tongue Function and Mobility

These treatments can aid in improving nasal breathing and the position & function of the tongue. They can also help open up the airway by expanding the upper jaw and advancing the lower jaw.

If the cause of snoring in children is enlarged tonsils and adenoids, we use a combination of breath retraining and myofunctional therapy. Here, surgery is recommended only when conservative approaches are not successful.

If obesity is the cause of snoring in children, dietary and lifestyle changes are recommended to maintain a healthy weight.

FAQs

1)Is snoring normal?

Snoring is common, but snoring at any age is not normal. Snoring or sleeping with your lips parted is an indication of not sleeping well. It prevents the child from transitioning into deep stages of sleep, which is important for the repair and regeneration of cells, hormones, and immune functions.

2)Don’t all children snore?

Almost everyone - children or adult - have occasional episodes of snoring. Here, it is important to note that the severity, frequency and impact of snoring can vary in children. Thus, if snoring causes disruption in sleeping patterns and becomes more frequent, it is a cause of concern as it could indicate the presence of SDB.

3)How is snoring diagnosed in kids?

Paediatric sleep-disordered breathing is diagnosed based on physical examination, medical conditions (down syndrome and cerebral palsy), family history of OSA, questionnaires, among others. If your child exhibits any of the above symptoms or is a restless sleeper, consult with a sleep disorder specialist. An airway focused specialist/dentist will thoroughly examine your child and identify issues causing snoring and breathing problems.

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