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Child's snoring may be harmful

By BRUCE A. EPSTEIN

© St. Petersburg Times, published September 7, 2000

Did you know that 20 percent of normal children occasionally snore and that 7 to 10 percent of children snore every night?

The noisy sound of snoring occurs when there is a blockage to the flow of air in the back of the mouth or nose. This area is the collapsible part of the airway where the tongue and upper throat meet the soft palate and the uvula (the fleshy structure that dangles from the roof of the mouth back into the throat). Snoring occurs when these floppy tissues strike against each other and start to vibrate during breathing.

Anything that limits the size of the airway may cause snoring:

  • Poor muscle tone in the muscles of the tongue and throat, which allows the tongue to fall back into the airway. This occurs when a child's muscle tone is very relaxed from sedating medications, for example. It also happens to some children when they relax into the deep stages of sleep.

  • Enlarged tonsils and adenoids can cause snoring in children. Cysts or tumors could be present, but this is rare.

  • An enlarged uvula may dangle into the child's airway.

  • A small jaw, Down's syndrome or other abnormalities of the facial development.

  • Obstructed nasal passages. When a child has a stuffy or blocked-up nose, he must blow hard to exhale air through it. This creates a vacuum in his throat, causing the collapsible part of the airway to pull the floppy tissues of the airway together. This explains why some youngsters snore during hay fever season or when they have a cold or sinus infection.

  • Congenital deformities of the nose.

    How can parents determine if their child's snoring is serious? Sleep specialists commonly place snoring into two categories: primary snoring and the kind of snoring associated with obstructive sleep apnea.

    Primary snoring is considered "normal" and is not usually harmful for your child.

    Children with obstructive sleep apnea typically will experience some difficulty sleeping at night and behavioral problems during the day. Signs of this condition include snoring during sleep and, in particular, a pause in the snoring of up to 10 seconds before breathing is resumed. This is followed by snorting, gasping for air or completely waking up before normal breathing is restored. Your child may be a restless sleeper, often waking.

    Other signs and symptoms:

  • Sleeping in an abnormal position, with head off the bed and elevated with extra pillows.

  • Falling asleep or excessive daydreaming.

  • Excessive sweating during sleep.

  • School or other behavioral problems (mimicking attention deficit syndrome).

  • Daytime fatigue.

  • Difficulty waking up, even though it seems he or she has had adequate sleep.

  • Headaches in the morning, or often during the day.

  • Irritable, aggressive or cranky.

    In severe cases, sleep impairment can lead to growth hormone deficiency, small build, hypertension and heart failure.

    Even simple snoring can be a problem for children. It can disrupt family life, make the snoring child an object of humiliation and cause other family members to lose sleep.

    In addition, the constant vibration can be tough on throat tissues, leading to infection. The snoring child does not get the rest she needs, bed-wetting is common and school performance can be affected.

    Parents of a child who snores would be advised to see the child's physician instead of trying to tune out the problem.

    Bruce A. Epstein practiced pediatrics in St. Petersburg for 26 years. He edits the Web site http://www.kidsgrowth.com.

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