Snoring symptoms in a young child

• Does the child snore?
• Does the snoring occur two to four nights a week (moderate snoring)?
• Or does it occur five to seven nights a week (habitual snoring)?
• Is it interrupted snoring where the child stops breathing?
• Does this interrupted snoring last four seconds or more at least twice per hour?
• Is your child hyperactive?
• Does your child lack attention (attention deficit)?
• Does the child have headaches in the morning?
• Does the child sweat profusely while sleeping?
• Is your child fidgety?
• Do you have trouble understanding the child’s speech?
• Does your child have trouble pronouncing consonants like P, B, V, T, etc?
• Is the child a restless sleeper?
• Does the child look sleepy during the day?
• Does the child do poorly in school, particularly in mathematics and spelling?
• Does the child breathe through the mouth?
• Does the child often wet the bed at night?
• Does the child grind his or her teeth?

Most of these problems, and many more, occur about twice as frequently in habitual snorers than in children who don’t snore. In fact, reviewing data (from Sahin, Eitner and Guenther, 2004) indicate that ADD, ADHD, daytime sleepiness, restless sleep, daytime mouth breathing, bed wetting, tooth grinding, poor school performance and morning headaches are 207 percent more prevalent in the habitual snorers than in non-snorers.

Because these characteristics are twice as frequent in habitual snorers, obviously it becomes extremely worthwhile to analyze a young child’s risk of a serious sleep problem.

What is the best way to proceed?

The first priority is to get more information from the parent by having them fill out a questionnaire.

If there is an indication that the child has any of the following symptoms — interruptions in the breathing while sleeping for four seconds or more; labored, difficult or loud breathing while asleep; cessation of breathing more than two times per hour while sleeping — the child should be suspected of having apnea or hypopnea and should have a home night sleep study and then possible referral to a sleep specialist.

One of the most common causes of sleep problems is unusual swelling of the tonsils and/or adenoids. If this is suspected, the child should be referred to his or her pediatrician.

However, if the child does not have the above symptoms, any one of three preformed appliances could be indicated. They are the Youth Habit Corrector (for open-bite, thumb sucking, mouth breathing and speech problems); the Nite-Guide appliance (for mouth breathing, mandibular retrusion, occlusion problems and snoring) and the Youth Snore Cure (for mouth breathing and snoring).

Such an analysis for sleep-related problems in your young patients should become part of the patient examination in your office.

(Note: This article was published in Ortho Tribune U.S. Edition, Daily at the AAO, Vol. 5, No. 2.)