You noticed that your child recently started snoring. When do you need to worry about it? The quick answer is:

1. You should be concerned if your child snores AND also has symptoms suggesting a more serious condition called obstructive sleep apnea syndrome or OSAS.

2. You should be less concerned if your child snores occasionally, but does not have symptoms of OSAS.

Here are some answers to common questions to help you determine in which category your snoring child falls:

Why do some children snore? Snoring is a common symptom in children. About one in 10 children snore. It occurs when a noise is generated during sleep due to a blockage in the throat that causes vibrations. Snoring occurs during sleep because the child is relaxed and the tongue falls back making the blockage more likely.

What is OSAS? OSAS occurs when this obstruction is bad enough that it interferes with breathing during sleep and even cause the brain to temporarily get less oxygen than it needs. The breathing pauses can lead to poor quality sleep.

The obstruction in children with OSAS is usually caused by enlarged tonsils or adenoid glands. Tonsils are the red glands in the back of the throat and adenoids are glands that you cannot see because they are situated between the throat and the inside of the nose.

Do all children with snoring have OSAS? Not all children with snoring have OSAS. In fact, most children with snoring do not have OSAS. This kind of snoring is called "primary snoring" meaning that the snoring is not related to OSAS.

How do I know if my snoring child also has OSAS? Your pediatrician should examine your child paying special attention to her growth, roof of the mouth, jaw, tonsils and nose, and ask questions to determine if OSAS is likely. OSAS is more likely if your child:

  • has loud snoring more than two nights a week

  • has difficulty in breathing during sleep

  • gasps for air after a pause in breathing during sleep

  • sleeps in a seated position

  • has excessive daytime sleepiness

  • starts wetting the bed after a long time of being dry

If my pediatrician suspect OSAS, what is next? Your pediatrician will either order a sleep study or have the child see an ear, nose, and throat specialist or a sleep specialist. A sleep study will determine if the child has OSAS by looking at the child's breathing, oxygen blood level, and brain activity during sleep. This is usually done overnight at a sleep center clinic.

What are the consequence of OSAS if not treated? OSAS is a serious condition that if not treated, can lead to one or more of these complications:

  • behavioral and social problems

  • school and learning problems

  • headaches during the day

  • excessive weight gain

  • symptoms of ADHD

A recent article described a study done at The University of Chicago involving public school children 5 to 7 years of age. The doctors tested the children on their intellectual, attention, memory, and judgment and abilities. Children that had snoring and OSAS did worse on these tests than children who had primary snoring or had no snoring at all. This seems to confirm the harmful effects of OSAS on learning in young children.

How is OSAS treated? OSAS in children is usually treated by surgically removing the adenoids and tonsils. This procedure helps the majority of children with OSAS. If the child is obese, losing weight might also help. IF the OSAS is mild, the nasal allergy spray might also help. Less often, children may be treated with CPAP or a machine that pushes air pressure into the nose at night.

In summary, snoring is common in children but only children with OSAS or obstructive sleep apnea syndrome (about one to three children out of 10 who snore) need further evaluation and treatment. If your child snores, then talk to your pediatrician and discuss if OSAS is likely!

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