The child snores.Symptoms may include snoring, teeth grinding, mouth breathing, labored or noisy breathing, wheezing, or sweating during sleep. These can negatively impact a child's development in several ways. Therefore, parents should learn about childhood snoring, its causes, and proper solutions. Furthermore, childhood snoring can be treated with various methods.CPAP machine and BiPAP machine Are they the same as adults? Find all the answers in the following article.

Snoring in children is a common problem in every country around the world and is often overlooked by parents who tend to think it's normal and harmless. In Thailand, research shows that about 10% of children snore, and of those, approximately 1% are preschool and elementary school-aged children.

Snoring in children: A health problem that requires attention.

Although snoring is relatively rare and often overlooked by parents who believe it's harmless, it can actually be life-threatening to children. Snoring is most common in children aged 2-6 years because at this age, tonsils and adenoids develop, causing airway obstruction and resulting in dangerous snoring sounds.

It has also been found that children with snoring problems due to airway compression, tonsil obstruction, or airway narrowing are at increased risk (10% compared to 20%). Of those, only 2% is present in very healthy children, which may be due to allergies causing them to breathe through their mouths, resulting in mild snoring that improves upon waking and does not pose a health risk.

Children who snore may have...sleep apnea

In the event that your child has...snoringIf your child regularly experiences noisy breathing, restless sleep, difficulty breathing, chronic nasal congestion requiring frequent mouth breathing, bedwetting, aggressive or hyperactive behavior, declining academic performance, or slower-than-expected growth, you should take them to see a doctor.

What causes children to snore?

Snoring in children is similar to snoring in adults, involving vibrations of respiratory structures such as the uvula and soft palate, which can become narrowed, causing snoring sounds.

The most significant and common causes of snoring in children include abnormally enlarged tonsils or adenoids, located at the back of the nose; chronic allergic rhinitis; and being overweight, which causes fat in the neck to compress the airway.

Other causes include congenital facial skeletal abnormalities, most commonly seen in children with Down syndrome, as well as genetic predispositions from one or both parents.

The most common and important cause in children is abnormally enlarged tonsils and/or adenoids, which are located at the back of the nose (not visible through the mouth).

In addition, chronic allergic rhinitis or obesity are also common causes. Other possible causes include facial deformities such as a narrow face, short or small chin, as well as genetic disorders or brain and muscle diseases that affect breathing.

Adenoids cause children to snore. — Figure 2 shows an image of the adenoids, which are located at the back of the nasal cavity.

Dangers and side effects.

Snoring in children can be a significant cause of developmental abnormalities, both physical and intellectual.
Risk of developing ADHD, learning difficulties, and poor academic performance.
Children with airway obstruction due to snoring may experience stunted growth, and exhibit unusually aggressive and mischievous behaviors that differ from those of typical children.
Children who snore have difficulty falling asleep in class because they don't get enough sleep at night. This can lead to irritability and difficulties interacting with classmates, causing them to become withdrawn and introverted.
Severe snoring can lead to sleep apnea. When breathing stops, blood oxygen levels drop. If left untreated and chronic snoring occurs in children, it can lead to an enlarged heart and even death.
Some children who snore may also experience frequent urination at night or regularly wet the bed.

How to spot abnormalities in children's snoring.

Parents may easily notice signs during their child's sleep, such as excessive sweating, labored breathing during sleep, sunken chest and neck, and a bulging stomach.
Frequent bedwetting, behavioral changes such as daytime sleepiness due to insufficient sleep, irritability, spoiled behavior, and disobedience towards parents or teachers are all signs of a problem.
Loud snoring, especially a gasping sound like someone struggling for air, and sudden awakenings after the snoring stops.
Pay close attention to your child's snoring. Listen carefully to whether the snoring is intermittent or if there are periods of pauses in breathing.

Diagnostic testing

If you notice that your child is snoring abnormally... You should take him to see a doctor. For children who snore, doctors will diagnose and perform a physical examination, including a sleep test to measure blood oxygen levels, respiratory system function, and sleep quality.

If parents notice that their child snores loudly regularly, tossss and turn in their sleep, or experiences sleep apnea, they should seek medical attention. You should take him to see a doctor.For a complete diagnosis, the doctor will perform a physical examination, assess the structure of the airway, and recommend a sleep quality test. Sleep test This allows for accurate assessment of respiratory function, blood oxygen levels, brain waves, and behavior during sleep, enabling targeted and timely treatment planning. This can help prevent potential long-term negative impacts on a child's brain development, concentration, and growth.

An accurate diagnosis requires a comprehensive medical history and physical examination, covering the head, face, ears, nose, throat, and mouth. Examination of the lungs and heart, or other relevant systems, is also necessary. Additionally, further tests are often performed, such as lateral head X-rays to visualize the width of the airways.

And, if possible, children who snore should undergo a sleep test to measure blood oxygen levels, respiratory system function, and sleep quality. This can be done in a hospital or at home. Sleep test at home It depends on each person's budget, suitability, and convenience.

Guidelines for caring for children who snore.

Guidelines for the management of snoring and sleep apnea in children include:

Monitor nutrition if a child is overweight.
Treatment with medication, such as nasal steroid sprays, allergy medications, or anti-inflammatory drugs to treat tonsils, is chosen according to the individual case.
Surgical treatment: Currently, the standard and most effective method is adenotonsillectomy (removal of tonsils and adenoids) because it is very safe with a low risk of complications and minimal impact on the immune system or subsequent infections. However, you must consult an ENT specialist with experience in pediatric surgery.
Maintain the cleanliness of your bedroom and bedding, including sheets, blankets, and other bedroom items, to prevent nasal irritation and protect against germs and dust that can cause various allergies and respiratory problems.
If you notice your child snoring more while sleeping, have them sleep on their side to reduce the snoring.
Provide care with respiratory support equipment, such as... CPAP machine Or, in cases where a child snores severely, it can also be used. BiPAP ventilator (Bi-level Positive Air Pressure) This device offers two pressure levels, effectively adjusting air pressure to suit a child's snoring symptoms.
See your doctor regularly and follow their advice to prevent sleep apnea from worsening and to avoid the need for surgery.

summarize

Snoring in children is very common and can occur at any age, even in infancy. In fact, snoring indicates a narrowing of the upper airway, which could be in the nose, throat, base of the tongue, or part of the larynx. This narrowing occurs during sleep, causing the airflow through these tissues to vibrate and produce a sound.

Snoring can have several negative health consequences, especially if... Pediatric Obstructive Sleep Apnea (OSA) This may lead to developmental abnormalities, both physical and intellectual, resulting in slow growth, aggressive behavior, or excessive hyperactivity.

Some children may wet the bed, leading to poor academic performance or social problems. Furthermore, if severe, it can be a cause and risk factor for high blood pressure and heart disease.

Based on the article "Snoring in Children...When Your Child May Stop Breathing".
By Assoc. Prof. Dr. Wich Bannahiran
American Board of Sleep Medicine, Certified International Sleep Specialist
Department of Otolaryngology
Faculty of Medicine Siriraj Hospital

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