Children snoring is a relatively common situation during childhood. In fact, one in ten do. “But just because it is common does not mean that we consider it normal,” warns pediatrician Lucía Galán. Most of the time, snoring is occasional and related to a catarrhal process. That is, the child becomes sick and snores that night or the following nights. «If the child breathes normally again as soon as the snot disappears, we don’t have to worry. These cases do not imply any risk to their health, but if the child snores regularly without being sick, sleep apnea syndrome (SAHS) should be ruled out, meaning that he or she takes breathing pauses while sleeping,” explains Dr. Galán, a well-known on social networks as ‘Lucía, my pediatrician’.
«Parents should consult with a specialist if their child snores at least three nights a week and does so with an intense sound. Furthermore, children who suffer from sleep apnea usually present a very characteristic physiognomy: elongated face with a lack of development of the middle third of the face (area of the cheekbones and nose) and greater asymmetrical growth of the jaw,” adds the Dr. Peter Baptista, president of the Snoring and Sleep Disorders commission of the Spanish Society of Otorhinolaryngology and Head and Neck Surgery (SEORL-CCC).
Respiratory pauses during sleep directly affect children’s health at all levels. «It is a very important disorder, which not only implies a decrease in the quality of life of the child but can also lead to a delay in learning, enuresis, bruxism, behavioral problems, psychiatric, neurocognitive, cardiovascular, metabolic and abnormalities. endocrine and growth,” highlights Dr. Baptista.
In the case of adults, severe apnea is understood to occur after 30 stops per hour, while in children the numbers are lower. “One or two an hour is considered a severe case,” the specialists agree. And this lack of a restful sleep at night – they suffer multiple awakenings of which they are not aware – has its consequences during the day. «Many of these children even fall asleep in class, so they can be diagnosed with attention deficit or learning problems by mistake. Paradoxically, other children present a state of permanent activity and excitability, in addition to being at greater risk of suffering from high blood pressure. “Teachers often describe them as students who can’t sit still, who bother, who interrupt, who don’t concentrate… When what really happens to them is that by not being able to rest well at night they are out of control during the day,” Dr. Galán specifies in ‘The great book of Lucía, my pediatrician’ (Ed. Planeta).
The causes that lead to obstructive sleep apnea are multiple, although in the case of children they are usually directly related to the size of the tonsils and adenoids. «It would not be the first time that a child is diagnosed with hyperactivity and what happens to him is that he cannot rest because he has tonsils and vegetations like fists. Finding out what is happening is as simple as asking the parents if their child snores many nights,” the pediatrician acknowledges.
If the answer is yes, the next step is to take a detailed medical history of the child. How do you snore? Is the noise very loud? Do you have apneas? Do you have a very restless sleep? Does he pee at night? Does he breathe through his mouth? Is it difficult to wake you up in the morning? Does he have concentration problems? Doesn’t it stop still? Has he stopped growing or gaining weight lately?…
Afterwards, an examination will be performed (tension, weight…) and, finally, “the most important step.” We will tell you to open your mouth to observe the tonsils and assess whether they are a normal size or too large (tonsillar hypertrophy). The vegetations, however, cannot be observed with the naked eye. They can only be seen with a tiny camera that ENT doctors use through a small tube inserted through the nose, the rhinoscope. This technique, simple and quick, provides a lot of information because it allows you to clearly visualize the size and degree of obstruction of the adenoids,” says Dr. Galán. The scans are usually completed with a sleep study, which will confirm whether the child has sleep apnea and to what degree.
The most indicated and common solution to correct the respiratory problems of these children is surgery. The intervention basically consists of removing (or reducing) the vegetations and tonsils so that air can circulate freely. “The adenotonsillectomy operation solves the problem in eight out of ten cases, although it is advisable to monitor the child because the symptoms can reappear months or even years later,” the Spanish Association of Pediatrics (AEP) states.
If the child maintains oral breathing after surgery, “it is important to examine him for nasal congestion, including septal deviations or allergic rhinitis. You can also consider having it examined by an orthodontist to complete the treatment,” experts advise.