(November 28, 2023) — Just like adults, children sometimes snore. About 27 percent of children experience minor, occasional snoring, but studies estimate that 1.2–5.7 percent of children are snoring because of sleep apnea, which can cause serious medical problems. So how can you tell if your snoring child has a problem?
Dr. Anuj Chandra, medical director of the Advanced Center for Sleep Disorders, suggests being alert for these symptoms:
- Sleeping in an unusual position, such as propped up with lots of pillows or with the head hanging off the bed
- Snoring loudly and often
- Briefly stopping breathing, often followed by snorting or gasping
- Heavy sweating
- School or behavior problems
- Difficulty waking up in the morning
- Headaches during the day
- Falling asleep during the day
- Bedwetting that is not outgrown
- Attention deficit disorder with hyperactivity (ADHD)
ADHD versus Sleep Apnea
The last item on this list is especially important, because some of these symptoms are similar to those of ADHD.
“Some children are misdiagnosed with ADHD, because of the problems coming from sleep apnea,” said Dr. Chandra. “In addition, some children have both ADHD and sleep apnea, with the apnea making the ADHD symptoms worse. If ADHD medications are not working as well as they should, you should always ask if there may be sleep problems as well.”
How Apnea Works
During sleep, everyone’s muscles relax. That includes muscles in the mouth and throat. If your child has sleep apnea the throat muscles may be relaxing too much. Or your child’s throat might be narrower than usual so “normal” muscle relaxation means the throat closes up a little.
For both kids and adults, apnea happens when the throat muscles slump down and partially close up. The result is that air coming through meets just enough resistance to stop the air flow for a few seconds before the air pushes through and makes that characteristic snoring or snorting sound. The real problem is not the sound. The problem is that your child actually stops breathing for a few seconds and is not getting enough oxygen.
Getting a Diagnosis
The only way to find out if your child has sleep apnea is to see a sleep specialist who works with children. If the doctor suspects apnea after an office visit, the next step is an overnight diagnostic test called polysomnography. Your child will stay overnight in a testing center — usually with a parent — and sleep with sensors attached to the head and body to monitor sleep patterns, brain waves, muscle activity, leg and arm movements, heartbeat, and breathing.
“After a sleep diagnostic test, we can tell if your child’s snoring comes from sleep apnea and how serious the apnea is, so we can decide on the best treatment,” said Dr. Chandra.
Surgery — Enlarged tonsils and adenoids are often the cause of sleep apnea in children, and they can be removed. Sometimes other structural problems in the mouth or throat might also require surgery. Surgery doesn’t always solve the problem — it might even stop the snoring but not end the sleep apnea — so another sleep study might be needed.
Continuous positive airway pressure (CPAP) — This is a treatment where your child wears a small mask over the nose that is attached to a machine that gently pushes air in to keep the throat from closing up during sleep. CPAP is the gold standard of apnea treatment for adults. Children, too, can get quite comfortable with CPAP and use it regularly, and obtain significant benefit with positive guidance and encouragement.
Weight loss — If obesity may be contributing to your child’s sleep apnea, weight loss through diet, exercise and lifestyle changes may be recommended.