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Snoring
can be a normal symptom of a cold or virus in children. But
when snoring persists and children have difficulty sleeping,
parents should take their children to a doctor to look for
signs of more serious conditions.
Snoring
occurs in about 20 percent of children and is most common
among children between 2 and 6, said Dr. Marcel Deray, a
pediatric neurologist and director of the sleep disorders
center at Nicklaus Children’s Hospital in Miami. About 10
percent of children who suffer from snoring have some sort of
obstructive sleep apnea, a sleep disorder that leads to pauses
in breathing throughout the night.
"That’s
the peak time that kids have enlarged adenoids and tonsils,
which is the main cause of snoring and sleep apnea,"
Deray said.
Besides
loud snoring, children may seem restless in their sleep, talk
in their sleep, sleep in abnormal positions or sleep walk.
Children may also begin wetting the bed again after not
wetting the bed for months. All of these nighttime behaviors
are signs that a child may need treatment for their snoring
and that it could be sleep apnea.
During
the daytime, children suffering from sleep apnea may wake up
tired, irritable, moody and with headaches. Teachers may
notice children falling asleep in class or having difficulty
paying attention.
Environmental
factors and allergens may also contribute to snoring. Children
who are exposed to smoking can snore more. Obesity can also
make children more prone to snoring because an obese person
can have difficulty breathing. Children with Down syndrome or
facial abnormalities are more likely to suffer from sleep
apnea because they have a greater chance of having a collapsed
airway.
"Some
risk factors [for snoring and sleep apnea] may be kids that
are overweight, so kids that have a body mass index (BMI) over
26. You want to be a little more proactive in screening for
sleep apnea," said Dr. Leonardo Torres, a pediatric sleep
specialist at UHealth-the University of Miami Health System.
DIAGNOSIS
AND TREATMENT
If a
doctor determines that snoring may be a problem for a child,
the next step is to try implementing lifestyle changes and see
if the child has a cold, viral infection or allergies.
Some
lifestyle changes that Dr. Nivia Vasquez, a pediatrician at
Baptist Health South Florida, recommends are eating a better
diet, exercising, decreasing environmental irritants and
avoiding smokers.
If those
changes don’t improve a child’s sleep or related symptoms,
a doctor will then recommend a polysomnogram, which is part of
an overnight sleep study. The polysomnogram measures brain
activity, eye movements, heart rate, blood pressure, oxygen
levels, air movement and chest movements.
Nicklaus
Children’s Hospital has recently opened a second sleep
disorders center in Weston at the Dan Marino Outpatient
Center. Deray helped open the original sleep disorder center
at Nicklaus in 1983.
"[The
sleep study] entails spending one night in the lab,"
Deray said.
After
identifying that a child has sleep apnea, the next step is to
identify the cause of the sleep condition. In almost all
cases, sleep apnea is caused by enlarged adenoids, soft tissue
behind the nasal cavities, and enlarged tonsils. To try to fix
the condition, doctors will remove the adenoids and tonsils in
a surgical procedure called a tonsillectomy and adenoidectomy.
"There’s
no side effects other than the surgery and the anesthesia.
There’s a very small risk of complication," Deray said.
After
surgery, children will be monitored in a sleep study to ensure
the cessation of snoring and sleep apnea. If children still
have difficulty breathing while sleeping after surgery, they
can be put on continuous positive airway pressure (CPAP)
therapy, where an electronic device delivers air to the
airways throughout the night to prevent the throat from
collapsing.
It’s
important to treat sleep disorders such as sleep apnea in
children because sleep deprivation and difficulty breathing
over a long period of time can lead to permanent health
problems. Permanent effects of ignoring sleep apnea include
being behind in school, not reaching optimal growth,
developing lung problems and behavioral changes.
"If
[sleep apnea] is ignored and intervention isn’t received,
the child could end up having permanent adverse effects, such
as health, behavioral or learning problems that could be
prevented if they received the intervention," Vasquez
said.
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WARNING
SIGNS
— Loud
snoring
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Hearing gasps or snorting during child’s sleep
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Restlessness
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Sleeping in abnormal positions
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Wetting the bed after not wetting it for six months
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Headaches in the morning
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Falling asleep in class
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Irritability
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Mouth breathing
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Sleep walking/talking
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Hyperactivity
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