“It’s more common than you would think,” said Dr. Janine Amos, a pediatric otolaryngologist who joined the Arkansas Children’s Northwest Ear, Nose and Throat (ENT) team in July. She is also an assistant professor of pediatric otolaryngology at the University of Arkansas for Medical Sciences. “I think the literature cites about 10 to 20 percent of children have some kind of snoring, and that can vary in severity.”

Amos sees patients that are newborns to 18 years old, splitting her time each week between surgeries and clinical appointments. She chose to specialize in pediatric otolaryngology, which treats conditions of the ears, nose, throat, head and neck, knowing she could make a difference for her patients because most ENT conditions are treatable.

“I just love working with kids. Kids are so much fun, and I see working with parents as well as an opportunity for me to be a teacher and to educate,” Amos said.

Causes of childhood snoring

Muscles relax while sleeping, including the muscles in the upper airway. If parts of the airway narrow or collapse while a person sleeps, breathing can cause a snore or other noisy sounds.

Most children who come to ACNW for snoring are ages 3 and up, but even some infants can snore. The clinic monitors whether a child’s snoring gets worse as they age, and if it does, it typically requires surgery.

A concerning cause of snoring in children is obstructive sleep apnea. The American Academy of Pediatrics defines it as a disorder that causes prolonged partial or off-and-on complete airway obstruction that can make breathing labored while sleeping. Because it disrupts restful sleep, it can cause a child to be more tired during the day, with sudden behavior problems and persistent bedwetting as they grow.

“If it’s left untreated for a long time, it can cause other issues with your heart and your lungs, so that’s the biggest concern with snoring,” Amos said.

Adults are often diagnosed with obstructive sleep apnea after a sleep study, which involves monitoring a person’s sleep pattern with sensors, usually in a sleep study clinic. However, children’s sleep studies are not always available or as accurate.

“So sometimes we will get a sleep study if we are either on the fence about what to do or if we are suspecting that the obstructive sleep apnea is very severe,” Amos said. “But for the majority of kids, we don’t get a sleep study because it’s just not practical.”

Other causes of snoring in children include:

  • Enlarged adenoids, nasal turbinates (small structures inside the nose that clean the air as a person breathes) or tonsils.
  • Allergies can contribute to snoring because of extra inflammation in the nose and mouth.
  • Obesity; weight loss helps reduce or eliminate snoring.
  • Family history; even though snoring in children and adults is different, if a parent had obstructive sleep apnea as a child and had their tonsils or adenoids removed, their child may need to have theirs removed.

Amos said if a child has mild obstructive sleep apnea, they’ll sometimes treat it with allergy medications or nasal steroids to see if the snoring clears up or improves.

Preparing for an appointment

It’s crucial to diagnose snoring sooner rather than later, as some treatment options, depending on the underlying cause, are easier to handle in children.

“If the answer is removing the tonsils and the adenoids, that is a surgery that is much easier to go through as a child than an adult,” Amos said.

Amos said it’s challenging for a parent or caregiver to describe snoring to a doctor and recommends taking an audio recording of their child snoring before their first ENT appointment. The recording should be clear enough to hear sound patterns, which can help indicate an underlying cause.

“What I’m looking for is how loud is the snoring? Is there gasping associated or pauses in breathing? There’s a number of things,” Amos said.

Amos said that if a child only snores when they are sick or if snoring is “soft or intermittent,” it is typically not a cause for concern.

An ENT appointment requires a referral from a child’s primary care physician. Here is what patients can expect from a first appointment:

  • Exam of the ears, nose and throat by an otolaryngologist
  • Discussing about the suspected cause of snoring
  • A treatment plan

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