Snoring isn’t good for children
© 2012 Roy Benaroch, MD
In children, snoring may be more of a problem than we thought.
A September, 2012 prospective study of 249 preschool children looked at parent-reported rates of persistent, loud snoring. About 10% of the 2-3 year old children in this sample had persistent, loud snoring—and these kids were much more likely to have significant behavior problems including hyperactivity, inattention, and symptoms of depression. Higher rates of snoring were found in homes with smokers, households with lower socioeconomic status, and among children who weren’t breast-fed—but even after controlling for these factors, snoring itself seemed to be associated with these behavior problems.
Previous studies have already documented that snoring is associated with poor school performance in older children, as well as decreased attention in adults. We also know that in its more severe form, snoring is associated with sleep apnea, which can cause heart and lung problems in adults if untreated.
Parents can look out for these signs of possible sleep apnea in their children:
- Frequent snoring (> 2 – 3 times per week)
- Labored breathing during sleep
- Gasps/snorting during sleep
- Prolonged bedwetting
- Sleeping in a sitting position
- Sleeping with the neck hyperextended (in a “looking up” position)
- Headaches upon awakening
- Daytime sleepiness
- Attention-deficit disorder or learning problems
In addition, the physical examination of children with sleep apnea can include overweight or underweight, big tonsils, poor growth, and high blood pressure. However, even without any of these findings, this recent study suggests that persistent loud snoring alone may have important consequences.
If your child is a loud snorer, look for the symptoms above and talk with the pediatrician. To know for sure if there are problems with breathing during sleep, a sleep study may be needed. Alternatively, some pediatricians may prefer to refer to a specialist like an ENT (ear-nose-throat) doctor for further evaluation.
Treatment can include a trial of medications. Though none are specifically FDA approved to treat snoring or sleep apnea, there is good evidence that inhaled nasal steroids may help, and a very recent study showed that a common asthma/allergy medicine called montelukast may also be worth a try. If medicines don’t work, or if symptoms are quite significant, the most definitive treatment is surgical removal of the tonsils and/or adenoids.