Occasional snoring during a cold does not necessarily indicate disease. Frequent snoring, however, especially when accompanied by pauses in breathing, should prompt assessment for sleep-disordered breathing.
Why do children snore?
- Enlarged tonsils and adenoids: among the most common causes of upper-airway narrowing.
- Nasal obstruction: from allergic rhinitis or respiratory infections.
- Excess body weight: may increase obstruction during sleep.
Which signs should parents look for?
- Loud, frequent snoring, especially on most nights.
- Breathing pauses, gasping, laboured breathing or repeated arousals.
- Restless sleep, sweating, mouth breathing or unusual sleeping positions.
- Poor concentration, hyperactivity, irritability or difficulties at school. Children do not always show the same daytime sleepiness as adults.
- Growth concerns in more severe cases.
Does snoring always mean sleep apnoea?
No. Snoring is a symptom; obstructive sleep apnoea involves recurrent partial or complete airway obstruction during sleep. The loudness of snoring alone cannot reliably establish severity.
How is it diagnosed?
An ENT assessment includes a sleep history, examination of the tonsils and nose and, where appropriate, nasopharyngeal endoscopy. A sleep study is the preferred test to confirm obstructive sleep apnoea and determine its severity. It is especially important when diagnosis is uncertain, there are significant comorbidities or surgery is being considered in a higher-risk child.
What treatments may help?
- Treatment of rhinitis: intranasal corticosteroids may help selected children when prescribed appropriately.
- Adenoidectomy and/or tonsillectomy: commonly considered when enlarged adenoids or tonsils contribute to documented obstruction. Not every child who snores needs surgery.
- Healthy weight support: where appropriate, with paediatric guidance.
- CPAP and specialist follow-up: for selected children with persistent apnoea or when surgery is not suitable or insufficient.
Nasal decongestant sprays are not a long-term treatment for childhood snoring and should not be used repeatedly without medical advice. Obstructive sleep apnoea can persist after adenotonsillectomy, so follow-up may be important.
When should your child see an ENT specialist?
Arrange an assessment for frequent snoring or any of the signs listed above. Episodes of severe breathing difficulty, blue discoloration or significant respiratory distress require urgent medical attention.
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