“I can hear her down the hall.”
“I don’t know how someone so small can make that kind of noise!”
These are all statements I have heard time and again from parents of young patients. You might have a snorer in your home, but does it matter? Should you care? What does all that noise mean? Isn’t sleep apnea something that only adults get?
What causes snoring?
Snoring is a common phenomenon in children of all ages. It is caused by partial blockage of air as it moves from the mouth and nose into the neck (trachea). There are a variety of factors that contribute to snoring.
Risk factors for problematic snoring include
- ages 2-6
- large adenoids and/or tonsils
- obesity/over weight
- neurologic conditions
- conditions that cause general muscle weakness
- small mouth/jaw or other condition that affects bone growth/size
Is all snoring a concern?
No, not all. If your child only snores when they are sick, or if they fall asleep in their car seat, or if you hear it for brief periods on rare occasions, it is not something to be concerned about.
When should I consider calling my doctor?
Most children will outgrow their snoring behaviors, but some will progress to sleep apnea.
You should make an appointment to discuss your child’s snoring if your child snores frequently and has one or more of these issues:
- You hear pauses in their breathing during sleep.
- You hear them gasp for air in their sleep.
- You observe them being woken up frequently or feel their sleep is disturbed by the breathing.
- Your child has suffered from night terrors or sleep waking.
- You describe your child as a “mouth breather.”
- You feel that they have an unusual quality to their voice or sound “nasal” or congested when they speak.
- Your child is overly sleepy in the morning or falls asleep too easily during the day (in class, bus, car), even on days you think they should have gotten enough sleep.
- Your child wants to sleep with a fan blowing directly on them.
What is sleep apnea?
Sleep apnea occurs when a child does not breath enough at night to properly supply the body with oxygen and to exhale waste gas like carbon dioxide. While snoring indicates a partial blockage of the airflow and breathing, apnea occurs when the flow of air is blocked entirely. These are basically invisible episodes of suffocation. Often a child will have to partially awaken to start the breathing process again.
What are the effects of sleep apnea on my child?
As every parent knows, we are not at our best when we are woken from sleep over and over. This is especially true for a growing child. The frequent wakening, even if it isn’t complete, combined with the lack of air flow, is hard on the brain and body.
Negative effects of sleep apnea in children can include
- stress on the heart
- high blood pressure
- changes in mood, depressed mood, or moodiness
- increase in negative behaviors at home or in school
- poor school performance
- learning and memory problems
- ADHD or attention issues
- poor growth
- decreased energy and activity
- bed wetting
I’m concerned. What’s the next step?
Call your doctor or pediatrician first. Meet with them so that they can examine your child’s airway and discuss the symptoms and concerns that you have. A formal diagnosis of sleep apnea requires a sleep study also known as Polysomnography. In addition to a sleep study, your physician may discuss referral to an ear/nose/throat (ENT) doctor and/or a pulmonologist (lung/breathing specialist) or a sleep specialist.
Sleep apnea is more common in children than many realize, and it effects much more than the peace and quite of your home. Start the conversation with your child’s doctor early and revisit the topic as your child grows and changes. Everyone will sleep better.