Why does a child snore?
In children, the airway is narrow, so even a small obstruction significantly interferes with breathing. The most common cause of constant snoring is the growth of the pharyngeal tonsil, that is, the adenoids, and the enlargement of the palatine tonsils. They are maximally large just in preschool and primary school age. The second most common factor is allergic rhinitis with constant swelling of the nasal mucosa. Less commonly, deviated nasal septum, polyps, excess weight, structural features of the jaws and lower jaw, as well as muscle weakness in certain diseases interfere.
- Adenoids
- Enlarged palatine tonsils
- Allergic or chronic rhinitis
- Deviated nasal septum
- Overweight
- Narrow upper jaw and malocclusion
- Passive smoking and dry air
Why is constant snoring dangerous?
There is a fundamental difference between simple snoring and obstructive sleep apnea. With apnea, breathing is interrupted for several seconds, oxygen levels drop, and the brain is forced to momentarily wake up to restore breathing. This is repeated dozens of times a night. The child formally sleeps for the allotted amount of time, but sleep does not restore strength. The consequences in children often do not look like drowsiness, but rather hyperactivity, irritability, difficulty concentrating, and decreased academic performance. If it lasts for a long time, growth, bite and heart function suffer.
- Stop breathing and drop in oxygen during sleep
- Restless sleep, night awakenings
- Hyperactivity, irritability, attention problems
- Decreased academic performance
- Growth slowdown
- Formation of adenoid type of face and malocclusion
What to tell the doctor
The doctor is interested in the details of night breathing, which only parents see. Observe several nights and note whether the child snores every night or only when he has a runny nose, whether there are pauses in breathing and how the child comes out of them, whether he breathes through his mouth, whether he sweats, in what position he sleeps. It is useful to record a short video of your sleep on your phone. Separately, note how the child behaves during the day: how sleepy or, conversely, overexcited, whether he complains of a morning headache, whether he speaks nasally or normally.
- How often does snoring occur and is it associated with a cold?
- Have you seen any pauses in breathing?
- Mouth breathing day and night
- Sweating and unusual sleeping positions
- Morning headaches, daytime sleepiness
- Behavior, attention, performance
- Bedwetting
Survey
They begin with an examination by an ENT doctor: he evaluates nasal breathing, the condition of the tonsils and nasal cavity. The key method is endoscopic examination of the nasopharynx, which allows you to see the adenoids and accurately determine the degree of blockage of the nasal passages. It is more informative than x-rays and does not carry radiation exposure. If there is a suspicion of respiratory arrest, polysomnography is prescribed - a sleep study with recording of breathing and blood oxygen saturation. If an allergy is suspected, an allergist is involved, and if there are malocclusions, an orthodontist is consulted.
- Examination by an otolaryngologist
- Endoscopy of the nasal cavity and nasopharynx
- Polysomnography for suspected apnea
- Pediatrician examination, height and weight assessment
- Allergy examination for rhinitis
- Consultation with an orthodontist for malocclusion
Treatment
Treatment is always aimed at the cause. For allergic rhinitis, the doctor selects therapy, eliminates contact with the allergen and achieves free nasal breathing - often this is enough. Vasoconstrictor drops are not suitable for continuous use: they are addictive and increase swelling. If the adenoids or tonsils significantly block the airways and there is apnea, surgery is discussed - adenotomy, if necessary with the removal or reduction of the tonsils. Modern endoscopic techniques allow tissue to be removed accurately and with short recovery times. Additionally important are weight normalization, adults not smoking at home, and air humidification.
- Treatment of allergic rhinitis as prescribed by a doctor
- Rinsing the nose with saline solutions
- Avoiding long-term use of vasoconstrictor drops
- Endoscopic adenotomy for significant adenoids
- Intervention on the palatine tonsils for apnea
- Weight loss, air humidification, smoke-free home
