Children and Snoring
There are 84 different ways your sleep can be negatively affected, according to the American Sleep Disorders Association. Insomnia, sleepwalking, talking or eating in your sleep, sleep apnea, bedwetting and snoring are just a few.
Of the 84 ways, snoring is one of the most common problems that affect millions of people throughout the world each night -- 35 percent of those people are children.
Experts say children need periods of uninterrupted sleep -- it is important for their physical and emotional health as well as growth and development. A good night's sleep helps children perform better at school, comprehend, problem solve and keep their attention on tasks. However, when a child has a sleep disorder, such as obstructive sleep apnea (better known as snoring), their sleep patterns may be disrupted, which affects how they function during waking hours.
According to the National Sleep Foundation, no one sleeps through the night without waking -- adults or children. From birth until death, people will go through various stages of light and deep sleep, as well as the normal cycles of awakening that occur within. The periods of wakening are brief, so we learn to return to sleep on our own.
In addition, since these episodes are so brief, we oftentimes don't even remember them in the morning. But when a sleep disruption occurs, our sleep patterns are altered. It becomes harder to fall back to sleep and the amount of deep sleep that we need for our bodies to regenerate is decreased, resulting in sleepiness or tiredness during the day, according to the National Sleep Foundation.
"Our bodies have a rhythm of sleep and waking that they repeat each and every night of our lives," says Dr. Stephen Sheldon, director of the sleep medicine center at Children's Memorial Hospital in Chicago. "If anything occurs that disrupts this rhythm, then a sleep disorder can occur which complicates how we sleep as well as how we function during the following day."
So how does snoring cause this alteration in sleep patterns? Sheldon says snoring is "the collapse of the upper airway -- usually the throat -- during respiration at night because of high resistance in the airway." As this resistance can make it difficult for a child to breathe easily during sleep, they may wake up abruptly to catch their breath or in some occurrences, the sound they are actually making when trying to get air -- snoring -- may wake them.
"Two of my three boys have allergies," says Adam Shoemaker, a father of three from Chester, Va. "They have always snored from time to time so I didn't think anything about it. But when the oldest began snoring and waking the other two up, I realized that it wasn't due to the allergies anymore. He would wake himself up, his brothers and at times even me."
Causes for Snoring and Sleep Apnea
There are various causes for snoring or obstructive sleep apnea. Dr. Sheldon says the most common cause for snoring in children is large tonsils and adenoids. However, there are other causes or conditions that will result in a child's snoring as well.
"There are a variety of medical conditions that can also attribute to the presence of sleep apnea," says Sheldon. "Snoring is commonly seen in medical conditions where there is decreased muscle tone such as with Down syndrome. It is commonly seen in children whose jaws are too small. Children who have had a repair of a cleft palate, they are prone to sleep apnea. Children with cerebral palsy or with tumors in their head and neck can also be prone to obstructive sleep apnea or snoring. In addition, children who are overweight and have a larger neck circumference may also snore. We see these children more commonly in the referral center because we are a referral center. However, they are nowhere near the most common cause of sleep disorder breathing; tonsils and adenoids are by far the most common cause."
"My oldest son has snored since the age of 6," says Carrie Eichler, a mother of three from Ashland, Ohio. "When it began to wake him up every night and he ended up being tired the next day, I knew it was time for him to see a doctor."
The presence of intermittent snoring -- when it only occurs from time to time -- does not indicate the presence of obstructive sleep apnea. Children who have frequent chest colds, sore throats or allergies may snore during these times but do not snore on a regular basis. It is the children who tend to snore every night regardless of their health that may need medical intervention, Sheldon says.
Signs and Symptoms
The signs and symptoms of snoring or obstructive sleep apnea may help in determining whether or not a child may need medical intervention. These signs and symptoms include:
- The presence of snoring, whistling or low pitched wheezing coming from the throat during sleep
- Restless movements or sleeping restlessly
- Frequent headaches in the morning upon waking
- Problems with memory or concentration
- Extreme daytime sleepiness that continues regardless of change in bedtime or waking time
If the signs and symptoms persist longer than a week, parents should seek medical attention and perhaps a referral to a sleep disorder center.
"I think the best place to start is the pediatrician," says Sheldon. "The pediatrician would do a comprehensive evaluation and would make appropriate recommendations. There are pediatric sleep medical centers available throughout the U.S. They are accredited sleep disorder centers that only see children and specialize in pediatric sleeping disorders."
The proper diagnosis of a sleep disorder can only be done in a sleep laboratory. Sheldon says there are other means of testing but none that offer a concrete, dependable diagnosis.
"No matter what the other specialists say, there is no other way to clearly diagnose obstructive sleep apnea syndrome except with a sleep study -- an overnight sleep study in a sleep laboratory," says Sheldon. "There is no other way to diagnose it as of yet. There are no screening tests, you cannot diagnose by history and home studies are generally inadequate."
Treatment for snoring or obstructive sleep apnea in children varies depending upon what the determining cause is found to be. The most common cause -- enlarged tonsils and adenoids -- is treated with a simple surgery to remove the cause. Children who snore because they are overweight are usually put on a moderated diet in an attempt to lesson the stress on the throat. Due to the wide variety of causes, treatment for snoring or obstructive sleep apnea must be individualized based on the results of sleep testing.
"There is no one treatment that is used for all cases of OSA just as there is no one antibiotic used for all illnesses," says Sheldon. "Parents need to begin by having their child evaluated by their doctor, get a referral to a sleep clinic and then choose the treatment best suited for their child based on the findings. It is not a difficult disorder to treat, just individualized."
What it all comes down to, Sheldon says, is children need sleep.
"And when something interferes with that needed sleep then it is up to the parents to do all they can to correct whatever problem exists," he says. "Ask any parent and they will tell you that when kids don't sleep well, it is not just their sleep that suffers."