By Thomas Grant
Director Cardiorespiratory Care
Many if not most children
snore on occasion, and about 10 percent or more snore on most nights.
Snoring is a noise that occurs during sleep when the child is breathing in
and there is some blockage of air passing through the back of the mouth.
The opening and closing of the air passage causes a vibration of the tissues
in the throat. The loudness is affected by how much air is passing through
and how fast the throat tissue is vibrating. Children who are three years
or older tend to snore during the deeper stages of sleep. Primary snoring is
defined as snoring that is not associated with more serious problems such
obstructive sleep apnea syndrome (OSAS), frequent arousals from sleep, or
inability of the lungs to breathe in sufficient oxygen.
Loud and regular nightly
snoring is often abnormal in otherwise healthy children. Sometimes it is a
sign of a respiratory infection, a stuffy nose or allergy; other times it
may be a symptom of sleep apnea. In 2002, the American Academy of
Pediatrics recommended that all children be screened for snoring and that a
diagnosis be conducted to determine if a child is experiencing normal
primary snoring or obstructive sleep apnea syndrome.
Contributing factors to
sleep apnea may be obesity, allergies, asthma, GERD (gastroenterological
reflux disorder), an abnormality in the physical structure of the face or
jaw as well as medical and neurological conditions. In children the most
common physical problem associated with sleep apnea is large tonsils. Young
children’s tonsils are quite large in comparison to the throat, peaking at
five to seven years of age. Swollen tonsils can block the airway, making it
difficult to breathe and could signify apnea. According to the National
Center for Health statistics, more than 263,000 children in the U.S. have
tonsillectomies each year and sleep apnea is a major reason.
During the night,
children with sleep apnea may:
▪Snore loudly and on a
regular basis
▪Have pauses, gasps and
snorts and actually stop breathing. The snorts and gasps may waken them and
disrupt their sleep.
▪Be restless or sleep in
abnormal positions with their head in unusual positions
▪Sweat heavily during sleep
During the day, children
may:
▪Have headaches, especially
in the morning
▪Have behavioral, school
and social problems
▪Be difficult to wake up
▪Be irritable, agitated,
aggressive and cranky
▪Be so sleepy during the
day that they actually fall asleep or daydream
▪Speak with a nasal voice
and breathe regularly through the mouth
If you suspect your child
may have symptoms of sleep apnea, talk to your doctor who may refer you to a
sleep specialist and or an overnight sleep study. This study will record
the child’s sleep, brain waves, body movements, heartbeat, breathing,
arousals and noises to determine a diagnosis. Sleep specialists have
special training in sleep medicine and can help to determine if your child
has primary snoring, sleep apnea or another problem. They can then offer
you the most appropriate treatment.
Tom Grant is the
director of cardiorespiratory care and sleep disorders laboratory at Pattie
A. Clay Regional Medical Center.
9/04
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