Introduction
Whilst snoring is very common in children who have a cold or flu, it is not normal when they are well. Sleep apnoea occurs when children have pauses in their breathing for a number of seconds. Children with sleep apnoea need to be treated because poor quality sleep can affect growth, concentration, behaviour and development. Abnormal growth and development of facial bones and teeth can occur if upper airway obstruction is left untreated.
Causes
The most common cause of snoring and sleep apnoea in children is enlarged tonsils and adenoids. Enlarged turbinates (swellings in the nostrils) due to allergies may contribute to snoring, as can a deviated nasal septum. Other less common causes include problems with jaw structure, neuromuscular disorders or syndromes.
Symptoms
Snoring that occurs each night, including when the child is well, is not normal. Witnessed pauses in breathing at night may be a sign of sleep apnoea. Bedwetting, restless sleep, sweating at night, teeth grinding, choking or gasping episodes during sleep, poor concentration and behavioral problems are all associated with sleep apnoea.
Diagnosis
The diagnosis in children can often be made clinically by a good history from the parents and a physical examination that concurs with the history. Bringing a video or audio recording of your child sleeping is very useful. An X-ray of the adenoids may be helpful in young children who will not tolerate nasendoscopy (looking into the nose with a small camera).
If there is doubt about the diagnosis, then a sleep study may be helpful. In children with syndromes, neuromuscular disorders or obesity, it is routine preoperatively.
Treatment
In some children who snore, nasal sprays that reduced the size of their turbinates can be helpful. For the vast majority of children with sleep apnoea, adenoidectomy and tonsillectomy are recommended as the first line of treatment (provided the tonsils/adenoids are large). Referal to other specialists (e.g. dental, orthodontic, sleep medicine) may be required in certain cases.
Dr Levin can discuss the treatment options for your child after taking a history and performing a thorough physical examination.