Does Your Child Snore while Sleeping?

What is snoring?

Snoring is the harsh noise produced due to obstruction in the breathing passage. The collapsible structures are the most common places which vibrate like tongue, Soft palate, nasopharynx, uvula, etc. Snoring could be one of the symptoms of Obstructive Sleep apnea Syndrome (OSAS).

Snoring always a part of Obstructive Sleep Apnea syndrome but not all snoring are Obstructive Sleep Apnea Syndrome.

Why does a child snore?

Snoring is caused by an obstruction in the air passage which could be due to minor problems like cold/ tonsils or due to serious issues like OSAS.

During sleep, the soft tissues relax and vibrate causing the sound c/as Snoring but when this soft tissue repeatedly blocks the airway to the extent that it causes interruption of normal breathing it’s c/as OSAS.

What are the conditions causing snoring?

• Chronic/ acute Tonsillitis
• Adenoid Enlargement
• Deviated Nasal septum
• Allergic Rhinitis
• Sinusitis
• Turbinate Hypertrophy
• Anatomical birth defects (Cleft lip/palate/ Birth syndromes)
• Central Conditions caused by Central nervous system
• Obesity

Is snoring dangerous?

It’s a common problem in children & the most common cause of snoring is Tonsils or Adenoids so it’s treatable most of the time by removal of the problem. If snoring is associated with OSAS then it’s a bigger problem. In adults, snoring is more complicated and is a multi-level disease.

How do we approach a child with snoring?

We should do examination of nose and throat then look for enlargement of tonsils or adenoids or turbinate and investigate the child.

• X-Ray Nasopharynx (Lateral View) for adenoids
• X-ray PNS (Water’s View) for Sinusitis, Deviated Nasal septum, Turbinate hypertrophy etc.
• Nasal Endoscopy if child is co-operative.
• Polysomnograhy (Sleep study) it’s a GOLD standard investigation for OSAS.

Which all departments should we visit?

• ENT/ Otorhinolaryngologist
• Pediatrician to rule out any health conditions
• Sleep Medicine/ Respiratory Medicine

Surgical approach to Snoring:

• Adenoid hypertrophy: Adenoids are Lymphoid tissue located at the back of the nose so it’s enlargement causes obstruction which could be treated by Adenoidectomy
• Chronic Tonsillitis: Chronic enlargement of tonsils may cause snoring, recurrent throat infections etc so it’s removal is beneficial, Tonsillectomy.
• Deviated Nasal Septum: DNS is a condition where the nasal bone is not midline and deviated to sides causing nasal obstruction it could be treated by Septoplasty.
• Turbinate enlargement: it could be caused due to DNS or sinusitis it could be reduced by cobalation/ cauterization/ reduction of the turbinate.
• Allergic conditions could be controlled by medication to certain extent.

Medical treatment:

• If the condition is mild then waiting & watching could be done.
• Allergic Rhinitis could be treated by anti-histamines or sprays according to the severity of the disease.
• CPAP (Central Positive airway Pressure) it provides respiratory support by masks/ nasal prongs in cases of severe OSAS with central causes or patients who does not get better with surgery.
• Few marketed products are available which claims to be anti-snoring but not much evidence is present supporting the claims. Anti-Snoring pillows, Anti-snoring sprays, anti-snoring tapes, breathing techniques etc.

Snoring could be independent symptom or could be a part of bigger disease, it’s always better to get it checked rather than ignore the problem.

I hope my post was helpful, I’ll be back with more be hooked on to my blog.

Be Healthy

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Reference

• https://emedicine.medscape.com/article/295807-overview
• https://www.mayoclinic.org/diseases-conditions/obstructive-sleep-apnea/symptoms-causes/syc-20352090
• Scott and Brown Otorhinolaryngology Ed 7.