What should I do if my child snores?

Author: Wang Guixiang, Chief Physician, Beijing Children's Hospital, Capital Medical University

Reviewer: Zhang Yamei, Chief Physician and Professor, Beijing Children's Hospital, Capital Medical University

Is snoring in children a disease? Does it need treatment? In our daily lives, many parents think that their children are sleeping soundly when they see their children snoring at night. In fact, this view is wrong. In fact, snoring in children is a disease. It is necessary to take the child to a regular hospital for treatment in time to eliminate the pathogenic factors so as not to affect the child's growth and development.

What causes children to snore?

The most common cause of children snoring when they fall asleep can be seen in the abnormal anatomical structure of the upper airway, which leads to varying degrees of airway stenosis, such as chronic rhinitis, deviated nasal septum, hypertrophy of nasal concha, nasal polyps, choanal atresia and nasal tumors, hypertrophy of adenoids, hypertrophy of tonsils, hypertrophy of the root of tongue, retraction of the root of tongue, etc. In addition, congenital developmental malformations, such as micrognathia, cranio-facial malformation, cyst of the root of tongue, obesity of children, and treatment with sedative drugs can also cause snoring at night and affect the quality of children's sleep. For preschool children or school-age children, the main problem of snoring is the airway stenosis caused by hypertrophy of adenoids and tonsils. As shown in Figure 1, the lateral nasopharyngeal film shows that the adenoids are hypertrophic and block the posterior nares; Figure 2 shows the hypertrophy of adenoids shown by the electronic nasopharyngeal endoscope.

Figure 1 Copyright image, no permission to reprint

Figure 2 Copyright image, no permission to reprint

What are the dangers of children’s snoring?

In addition to the symptoms of snoring, some children may also have open mouth breathing, breath holding, repeated awakening during sleep, frequent limb tossing, etc. These snoring children may also have symptoms such as bedwetting, night sweating, abnormal sleeping posture, and repeated respiratory tract infections. Snoring for a long time will also disrupt normal ventilation and sleep structure during sleep, leading to hypoxemia, affecting the secretion of growth hormone in the brain, thereby affecting the growth and development of children, and then causing inattention, hyperactivity, memory loss, poor academic performance, neurobehavioral changes, cognitive dysfunction, etc. There may even be serious conditions such as growth retardation, hypertension, heart enlargement, and cor pulmonale. In addition, we also need to pay attention to the fact that when children snore, due to long-term open mouth breathing, the upper and lower teeth bite abnormally. Over time, it can lead to facial deformity, manifested as elongated maxilla, high arched palate, uneven teeth, protruding upper incisors, thick lips, lack of facial expression, forming an "adenoid face", lowering the child's appearance.

Do you need immediate treatment if you snore while sleeping?

First of all, parents should pay attention to the duration and frequency of the baby's snoring, whether it snores all night, whether the snoring is aggravated when the baby has a cold, and whether it is accompanied by breath holding and apnea. If the baby only snores for a short time after falling asleep, and does not affect the baby's deep sleep, or the snoring can disappear after improving the body position, and the baby has no nasal congestion, no mouth breathing, no breathing effort during sleep, and no apnea, it is not necessary to deal with it temporarily, and try to let the baby sleep in the side position. If the baby snores all night and is accompanied by long-term mouth breathing and breath holding, and parents can find that there is spitting at the corners of the mouth, always feels thirsty and dry mouth after waking up, lacks energy during the day, and the child is easily sleepy after getting up, has difficulty concentrating, and wets the bed at night, then the child should be taken to the ENT department for diagnosis in time to clarify the cause. Electronic nasopharyngeal endoscopy is currently a commonly used method to examine the narrow plane of the upper airway, and polysomnography (PSG) can help determine the severity of the disease.

Now that we know the cause of children’s snoring, how should we treat it?

The causes of snoring in children are different from those in adults, so the treatment methods are also very different. A reasonable treatment plan must be given based on the specific situation of the child. Some children have mild symptoms and a short medical history, so they can first try conservative drug treatment. Most children will have significant relief of symptoms after conservative drug treatment. If examination shows that the main cause of snoring is enlarged adenoids and/or tonsils, and the child's snoring symptoms recur and the snoring history is long, then the preferred treatment is adenoidectomy and tonsillectomy. For children with contraindications to surgery, small adenoids or tonsils, symptoms that persist after adenoids or tonsillectomy, and those who choose non-surgical treatment, non-invasive ventilator treatment, that is, continuous positive airway pressure therapy, can be used. In addition, in the treatment of rhinitis, obese children should control their weight, and the use of oral appliances can also play a certain therapeutic role.

How to prevent snoring?

Parents should pay attention to keeping their children's nutrition balanced to prevent obesity due to overnutrition; ensure regular work and rest time and reduce intense activities at night; pay attention to strengthening the body's resistance, reduce the occurrence of various acute and chronic respiratory infectious diseases, and avoid upper respiratory tract obstruction caused by inflammation. Only in this way can the occurrence of snoring symptoms be effectively reduced.

Only when babies have effective sleep can they be more energetic to welcome and explore this new and beautiful world. Let us work together to protect the sleep of babies!