Is Your Child’s Snoring Serious? Understanding Pediatric Airway Obstruction

As parents, we often cherish the peaceful sight of our children sleeping soundly. But what if their sleep isn’t as restful as it seems? Snoring in children is often dismissed as harmless, but in some cases, it could be a sign of an underlying sleep issue. From mild congestion to more serious conditions like sleep apnea, snoring can affect your child’s rest, energy levels, and even overall health. In this blog, we’ll explore the possible reasons behind your child’s snoring, when to be concerned, and what steps you can take to ensure they get the quality sleep they need.

What Causes Snoring?

Snoring in children is often brushed off as harmless, but in some cases, it could indicate an underlying sleep issue. While occasional snoring can be innocuous, persistent or louder snoring may interfere with restful sleep and affect your child’s well-being. Understanding the common causes of snoring in children can help you determine whether it’s a minor issue or something that needs medical attention.

1. Mouth Breathing

Mouth breathing is the biggest contributor to inflammation in the tissues of the airway which can lead to snoring. This bypasses nitric oxide production, leading to lower oxygen exchange efficiency and we don’t get the benefits of nasal breathing helping to regulate the breathing patterns thus impacting the sleep quality.

2. Nasal Congestion and Allergies

A stuffy nose from a cold, flu, or seasonal allergies can block the airways, making it harder for your child to breathe at night. This congestion forces them to breathe through their mouth, leading to inflammation of the tissues further contributing to snoring. It’s important to know that the nose is a use it or lose it type of organ! The longer the nose is unused due to congestion, the more congested they will be.

3. Enlarged Tonsils and Adenoids

Tonsils and adenoids play a role in fighting infections, but if they become enlarged due to mouth breathing or pathogens, they can obstruct the airway and cause more obstructive snoring. This is one of the most common causes of persistent snoring in children and may require medical evaluation, especially if it leads to breathing difficulties during sleep. Rest assured, there are also non-surgical options to address this as well!

4. Sleep Disordered Breathing or Obstructive Sleep Apnea (OSA)

Snoring can be a symptom of sleep disordered breathing or even as severe as obstructive sleep apnea (OSA). OSA is diagnosed with pauses in breathing exceeding 10 seconds in length, while any repeated pauses under that may be considered “less severe” and fall into the SDB category. OSA or SDB in children can lead to restless sleep, daytime fatigue, and even behavioral issues. Symptoms of sleep disordered breathing include gasping for air, pauses in breathing, and frequent waking at night. If you notice these symptoms, consult your pediatrician or local airway dental provider.

5 Other contributing factors include structural things like a deviated septum, sleep position, or exposure to irritants can also contribute to snoring.

Recognizing Red Flags: When Snoring Signals a Problem

The cause of a child’s snoring can be the biggest red flag you have to dig into your child’s airway health.

A study in the European Respiratory Journal states, snoring in children indicates increased upper airway resistance during sleep and is the cardinal symptom of sleep-disordered breathing (SDB). The complications of SDB are potentially severe and include neurobehavioral and cardiovascular complications and growth inhibition. Habitual snoring (HS), snoring on almost all nights in so-called primary snorers, has been associated with behavioral problems and poor academic performance even in the absence of intermittent hypoxia, possibly due to increased sleep fragmentation.

Essentially, just because your child doesn’t show any other negative implications of snoring, doesn’t mean it’s not impacting them. You may not notice signs of sleep deprivation now, but if your child is snoring – that’s enough of a red flag to dig deeper!

When to See a provider about Snoring

Occasional snoring due to a cold or allergies is usually not a concern. However, you should consult a doctor if:

• Your child snores audibly and regularly.
• They have pauses in breathing, gasping, or choking sounds during sleep.
• They seem excessively tired during the day or have trouble focusing.
• Snoring is accompanied by restless sleep or frequent awakenings.
• Your child exhibits other symptoms along with snoring such as grinding, mouth breathing, crowded or crooked teeth, dark circles under their eyes, restless sleep, bedwetting or behavioral challenges.

It’s ideal to seek the guidance of an airway trained professional if you are concerned about your child. Understanding pediatric airway health is a special niche and shouldn’t be taken lightly.

Diagnosis and Treatment Options

New guidelines from the American Academy of Pediatric Dentistry includes more detailed assessment methods, treatment options, and considerations for specific patient populations with SDB concerns.

If you are concerned about your child’s audible breathing at night here are some common treatment options:

1. Watchful waiting, while often recommended, should never be the option when it comes to audible breathing.
2. Early identification with routine dental checkups with your dentist to catch potential issues early on. The updated standards form the ADA highlight the importance of early screening for SDB in children.
3. Seeking a more comprehensive evaluation with an airway dental professional, or myofunctional therapist. This could include a more detailed assessment of a child’s facial structure, airway evaluation, sleep history, and potential risk factor for SDB with a reputable provider locally to you. AOMT, Airway circle, Breathe institute, Airway health solutions are all great places with directories to help you find a provider in your area.
4. Interdisciplinary approach: There is a huge importance for collaboration between dentists, pediatricians, and sleep specialists for diagnosis and planning of SDB.
5. Treatment could include updated recommendations regarding the use of oral appliances, lifestyle modifications, and potential need for further medical interventions depending on the severity of the SDB.

Practical Tips for Parents to Reduce Snoring

If your child snores, here are some practical tips to help reduce snoring, focusing on nasal hygiene and Buteyko breathing exercises:

Improve Nasal Hygiene

Keeping the nose clear is crucial for reducing snoring. Try these steps:

• Saline Nasal Rinse: Use a saline spray or rinse (like a neti pot) to clear mucus and allergens.
• Steam Inhalation: Have your child inhale steam before bed to open nasal passages.
• Humidifier in the Bedroom: A humidifier prevents dry air from irritating the nasal passages.
• Eliminate Allergens: Wash bedding regularly, remove dust, and consider hypoallergenic pillows.

Encourage Proper Breathing with Buteyko Exercises

The Buteyko method helps children breathe through their nose and reduce mouth breathing, a common cause of snoring. Try these:

1. Nasal Breathing Training: Encourage your child to keep their mouth closed and breathe through their nose during the day.
2. Light Breath-Hold Exercise:

1. Inhale through the nose gently.
2. Hold their breath for a few seconds.
3. Exhale slowly through the nose.
4. Repeat 5 times.

3. Relaxed, Slow Breathing: Guide your child to take slow, shallow breaths through the nose to prevent over-breathing.

Maintain a Healthy Lifestyle

Ensure a healthy diet and regular exercise to prevent excess weight, which can contribute to snoring. In addition, establishing a consistent bedtime routine for proper rest can also help reduce snoring.

Final Thoughts

As a pediatric sleep consultant, often families come to me about the duration or delayed onset of their child’s sleep. Research has indicated about 12% of children snore on a regular basis, but in our day-to-day encounters with families, this number seems to be much more and increasing rapidly.

Sleep is much more than that. The quality matters just as much! It’s my goal to empower parents to become the lifeguard of their child’s sleep and it’s much more than just sleeping through the night.

While snoring in children is often deemed harmless, it is a signal of an underlying sleep issue. The way your child breathes matters and there are providers willing and available to help! 90% of children with OSA are never diagnosed, so knowing what the red flags are and knowing what questions and who to ask can be the first line of defense. Early intervention can significantly improve your child’s sleep quality and overall health!

By identifying the cause, you can take steps to improve your child’s sleep quality and overall health. If snoring persists or is accompanied by other concerning symptoms, seeking medical advice is the best course of action.

** American Academy of Pediatric Dentistry. Policy on obstructive sleep apnea (OSA). The Reference Manual of Pediatric Dentistry. Chicago, Ill.: American Academy of Pediatric Dentistry; 2024:139-42

By Melina Moses, Senior Sleep Consultant & Airway Specialist