Child Snoring and Loud Breathing During Sleep

Snoring is loud breathing that occurs during sleep and can be found in individuals of all ages and sexes. Studies have found that about 3 – 12% of children snore. Snoring is especially common in preschool-aged children due to the relative size of their adenoids and tonsils when compared to the size of their airway.

Dangers of Snoring

Snoring can be dangerous if it occurs together with reduced or ceased breathing during sleep (Obstructive Sleep Apnea Syndrome), which can lead to lowered blood oxygen levels, insufficient oxygen supply to the brain, struggling to breathe due to obstructed airways, restlessness, frequent awakening, leading to poor quality of nighttime sleep and inadequate sleep. This can affect daily life, learning, and a child’s development.

Obstructive Sleep Apnea Syndrome (OSAS)

Obstructive Sleep Apnea Syndrome (OSAS) is a breathing disorder that occurs during sleep, caused by partial or complete obstruction of the airway. It often happens intermittently during sleep, disturbing the respiratory system and sleep patterns. The occurrence rate is about 2% in the population, and it is equally found in girls and boys. Although the harmless variant is more common, it is essential for doctors to diagnose and promptly treat children exhibiting the dangerous variant or respiratory abnormalities to prevent complications.

Children at risk of (OSAS) include:

• Those with enlarged tonsils and/or adenoids
• Overweight children
• Those with abnormalities in the structure of the respiratory system, such as a small jaw or a narrower than usual airway
• Those with brain abnormalities that cause abnormal control of the respiratory muscles, such as Cerebral Palsy
• Children with muscle weakness due to various causes
• Children with genetic disorders, such as Down syndrome
• Children with chronic pulmonary diseases

Suspicious Symptoms

• Struggling to breathe
• Difficulty breathing
• Pausing breathing intermittently
• Restless sleep, excessive sweating during sleep
• Frequent awakening at night
• Bed-wetting, although previously controlled
• Breathing through the mouth
• Learning difficulties
• Behavioral issues, short attention span, inability to sit still
• Lower than normal intellectual level
• Excessive sleepiness during the day
• High blood pressure

Sleep Diagnosis

Currently, diagnostic tests are available to detect sleep disorders, including overnight pneumogram testing, which lasts about 8 hours. Children may stay overnight in the prepared test room, and their guardians can accompany them.

Treating Sleep Disorders in Children

If a child is found to have a dangerous condition, it is necessary to treat it based on the cause, whether it’s removing the adenoid and tonsils in cases where these are enlarged – a procedure that can remedy airway obstruction during sleep by 75 – 100%. For patients with airway obstruction during sleep caused by other reasons, or who still have issues after tonsil removal, or those with health issues preventing surgery, a breathing assist device (CPAP or BiPAP) is necessary to prevent obstruction during sleep.

Treatment by surgery to correct abnormalities in the upper airway structure that is narrower than usual includes Craniofacial Surgery, Uvulopharyngopalatoplasty.

Treatment of other symptoms that may be contributing factors to abnormal breathing during sleep includes allergy management, weight control.

Complications

If a child has obstructed airways during sleep, leading to reduced blood oxygen as mentioned earlier, without timely treatment or correction, it could lead to:

• Lower intellectual level
• Reduced learning capacity
• Short attention span
• Hyperactivity, inability to sit still
• Excessive daytime sleepiness
• Bed-wetting
• High blood pressure
• High pulmonary blood pressure
• If left untreated, it could lead to heart failure