Introduction
Snoring sounds are caused when the tissues at the upper end of the airway strike and vibrate against each other. Newborns make heavy noises while sleeping which may appear as snoring since the air passages in newborns are small and there can be extra mucus or dryness which produces the sounds. Snoring once in a while is normal but regular snoring needs to be addressed as it can denote an underlying medical condition.
How Common Is Snoring In Children?
Normal, less frequent episodes of snoring which do not indicate any health condition are common in 27 % of the children. About 1.2 to 5.7 % of the kids have a condition called obstructive sleep apnea in which there are short pauses between breathing due to obstruction in the upper airways. Primary snoring without the presence of other symptoms is common in 10 to 12 % of children. Parents may find it difficult to notice snoring in children at night but can be identified with other signs.
What Are The Types Of Snoring?
Snoring varies in frequency, impact, and severity. Different types of snoring are as follows:
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The most common type is minor snoring which occurs in children as well as in adults and is short-lived. It does not reflect any health issues.
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More frequent snoring which disturbs sleep can be related to sleep-disordered breathing which varies in seriousness.
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A snoring frequency of more than two times a week in a child and which is not connected with any medical issues is called primary, habitual, or simple snoring.
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Frequent pauses in breathing that occur multiple times per night due to blocked airways can signal the presence of obstructive sleep apnea in children and require medical attention. It can impact the physical, mental, behavioral, and learning abilities of the child.
Why Do Babies Snore?
Babies can snore because of the following conditions:
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Stuffy Nose: Stuffy noses are common in babies that can cause difficulty in breathing but can be corrected by administering saline drops or any other medication as prescribed by the pediatrician (child specialist). As the baby grows, the nostrils increase in size, and the snoring resolves. If the snoring does not get corrected even after medications, then medical help is required.
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Enlarged Or Swollen Tonsils And Adenoids: Tonsils and adenoids are part of the body’s immune system and are located on the posterior part of the throat. Snoring can happen if they are naturally enlarged or enlarged as a result of infections.
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Laryngomalacia: The soft tissues of the larynx (voice box) become soft and the structural variation in the larynx makes it floppy and causes the tissue to hinder the air passage leading to partial obstruction. The condition resolves in 90 % of children by 18 to 20 months of age but few might require surgery.
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Allergies: Allergies can cause nose and throat inflammation which can hinder breathing and cause snoring.
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Asthma: Asthma can cause partial obstruction of airways and affect breathing.
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Structural Variations: Few children can have structural abnormalities at birth such as unequal separation of nostrils (deviated septum) that causes snoring as a consequence of mouth-breathing.
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Smoking: Smoking in the vicinity of the babies can affect breathing and lead to snoring.
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Contaminated Air: Impurities or poor quality of air can interfere with normal breathing and trigger snoring.
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Premature Apnea: Babies born prematurely around 34 weeks can develop premature apnea because of an underdeveloped respiratory system in these babies.
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Other Body Issues: Frequent snoring accompanied by poor weight gain can suggest problems in the heart, throat, or lungs.
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Obesity: Children who are obese or overweight can have narrowed air passages and are susceptible to snoring as a result of obstructive sleep apnea.
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Birth Defects And Other Disorders: Birth defects like cleft lip or palate (openings or splits in the lip or the roof of the mouth), genetic disorders like Down Syndrome (the child has three copies of chromosome 21 instead of two copies), neuromuscular disorders like cerebral palsy (brain damage that causes loss of control of arms and legs), muscular dystrophy (a hereditary condition that causes progressive weakening and wasting of muscles) and Sickle cell anemia (change in shape and damage of red blood cells) can make children more prone to snoring.
When To Consult A Doctor If The Child Snores?
Peaceful and relaxed sleep replenishes the energy and contributes to the physical and mental well-being of babies. Snoring occurs as a result of difficulty in breathing which can disturb sleep. So, snoring can be a cause of concern if:
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Babies appear tired or sleepy during the day.
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Restless or cranky during the day.
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Poor performance at school in the case of older children.
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Short gaps between breathing while sleeping.
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Loud or shrill wheezing sounds.
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Snoring multiple times a week.
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Obesity.
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Stunted growth.
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Bedwetting.
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Inattentive.
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Difficult to awaken in the morning.
How Is Snoring Diagnosed?
Parents are suggested to record an audio or a video of their babies snoring and then show it to the pediatrician for evaluation. The National Sleep Foundation recommends sleep tests (polysomnograms) be performed in older kids or toddlers to assess the degree of obstruction. Other tests include:
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An otolaryngologist (ear-nose-throat doctor) will examine the throat, neck, nose, mouth, and palate for any abnormalities. Based on the findings, a sleep study may be suggested to assess sleep apnea.
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Endoscopy to view the airways directly.
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Pulmonary function tests (PFTs) to examine the lungs.
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Computed tomography (CT scans).
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Magnetic resonance imaging (MRI).
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Swallowing and voice screenings.
What Are The Red Flags Of Sleep Apnea?
The five major red flags that indicate sleep apnea (a serious sleep disorder in which breathing stops and starts repeatedly are:
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Frequent night snores in a week.
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Noisy snoring.
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The child sleeps with their mouth open or with an extended chin and neck.
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Lapse in breathing or gasping for breath while sleeping.
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Frequent snoring that repeats for consecutive weeks.
How To Correct Snoring In Children?
It is important to consult a pediatrician if the above signs are noticed. The pediatrician will look out for signs of allergies and give medications to get rid of allergies. Other treatment methods include:
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Surgery: Surgery is indicated in children with enlarged tonsils or adenoids but with the current developments in antibiotics (medicine that destroys bacteria and resolves infections) and other strict guidelines, surgery is less common. However, surgery remains the first line of treatment in children with obstructive sleep apnea and 80% of the children become normal after the surgery. Surgical methods include removing the tonsils called a tonsillectomy, removing the adenoids called adenoidectomy, or removal of both called adenotonsillectomy.
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Positive Airway Pressure Devices: These are devices that direct pressurized air through a mask that covers only the nose or the nose and mouth. The air enters the mouth and airways to relieve the obstruction. Based on the control of airflow, the devices can either be continuous (CPAP) or bi-level (BiPAP). Positive airway pressure devices are mostly used in adults but are preferred in children who do not respond to surgery.
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Weight Reduction: Since obesity can narrow the airways, weight reduction is suggested in obese children.
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Sleep Habits: Small changes like a fixed sleeping schedule, less screen time before bed, a quiet, comfortable sleeping environment and less light exposure can promote healthy sleep. Poor sleeping habits can amplify health, behavioral, and thinking problems.
Conclusion
Snoring in babies can rarely signify a serious health issue. As the nasal passages enlarge with growth, snoring gets corrected. Stuffy nose or nasal congestion can be the common cause of snoring which can be resolved by medications. If snoring occurs repeatedly or if the above-mentioned signs are noticed, an appointment with a pediatrician may be required.
