Continuing our video series, Dr. Jerome Hester explains “Why does my child snore?”
Snoring in an adult can be a humorous or societal issue. However, snoring in a young child actually more commonly is a significant medical issue. Snoring occurs when there’s obstruction of the airway, and this leads to narrowing of the airway and obstruction to air flow, causing vibration of tissue.
In an adult, approximately 80% of all habitual snorers have sleep apnea. However, that number approaches 100% in children who are habitual snorers. Therefore, this truly demands that if a child is a snorer night in and night out, or at least most nights, that they truly should be evaluated by a specialist.
Many times, such issues are attributed to allergies or nasal congestion. Although those issues may play a role occasionally in children, they are rarely the cause of the issue. The most common cause in children is the enlargement of tonsillar or adenoidal tissues. The adenoids are tissue very similar to tonsils, but behind the child’s nose, and therefore out of view of most routine examinations.
If one does have a child who snores, remember that the presence of sleep apnea in a child is rarely accompanied by the typical signs of poor sleep such as fatigue or complaints about sleep. Actually, in the younger person, if anything, it is actually much more common that the child will have issues with attention span, concentration issues, perhaps even behavioral issues, and in fact, many times will actually have decreased growth because of the lack of deep sleep. Therefore, the recommendation for any child who snores regularly is an evaluation by an individual who specializes in sleep medicine and evaluation of the airway. In adults, we commonly recommend for all patients that they obtain a sleep study, a test where a patient is monitored overnight to look for obstruction. That still is a very useful test in a child, but it is not as diagnostic in a child as it is in an adult, and therefore, consideration by your physician may be that evaluation just by a physical examination and a history is enough to warrant proceeding with treatment.
Treatments in children can involve non-procedural treatments such as CPAP, although tolerance of this treatment in a child is very, very low. The procedural treatments indicated are most commonly removing the tonsil tissue, removing the adenoid tissue, and shrinking inflammatory tissue in the nose known as turbinates. That surgery is very common and is very effective for treating these individuals, but full evaluation of the patient should be made before any treatment is initiated.