By Khalid Ismail, MD
Any disruption to a child during sleep can be a cause for concern for parents. Proper sleep is important to a child’s growth — both physical and mental. During deep sleep, growth hormone production peaks, a necessary boost for growing kids. Most children around 4 years of age require 10 to 13 hours of sleep a day.
If your child is not getting enough sleep, or perhaps not able to get the quality of rest they need, other concerns can arise. Problems may include loss of appetite, behavioral problems, and growth complications.
When dealing with snoring, most often we are talking about an issue related to the upper airways. If your child has a cold or sounds congested, snoring can be expected, as long as it goes away once the cold is gone. However, if it persists, your child may be dealing with allergies or enlarged tonsils; it is worth talking to your child’s pediatrician. Long-term snoring in a child could be — but is not necessarily — a cause for concern. And, while children can experience sleep apnea, not everyone who snores has sleep apnea.
When someone has sleep apnea, their tongue can fall back and block their throat, so their levels of oxygen drop while they are asleep. That added stress can cause a child to be roused from sleep and can become very disruptive.
More than one episode of throat obstruction per hour of sleep is considered abnormal and may be diagnosed as obstructive sleep apnea in children. The severity of the sleep apnea depends on the number of times these episodes occur and awakens the patient during sleep. Although most likely related to large tonsils in children, sleep apnea, like in adults, can be more common in overweight children.
If you choose to reach out to your child’s pediatrician, it will be helpful if you have specific information about your child’s snoring and sleep behavior, particularly related to the extent of their snoring, whether they are waking up at night, or even talking in their sleep. Specifically, you may want to ask the pediatrician to check your child for enlarged tonsils or adenoids. Enlargement of either the tonsils or the adenoids could obstruct airways and be the cause of your child’s snoring. Depending on initial testing and diagnosis, the doctor may pursue any number of options, including nasal allergy medicine at bedtime, a sleep study, or potentially even surgery, if necessary.
You’re most familiar with your child. If their daytime behavior seems off, they are unfocused, or if they have a hard time following instructions — outside of the ordinary — this could mean their sleep is being disturbed. Reaching out to their doctor for a visit is always the first and best plan of action.
Khalid Ismail, MD, is Director of the Sleep Medicine Fellowship Program, Co-Director of the Mycobacterial Disease Clinic, and a Pulmonary Attending Physician at Tufts Medical Center. He is an Assistant Professor at Tufts University School of Medicine.