Snoring and Sleep Apnea

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What are snoring and sleep apnea?

These are sleep disturbances affecting children.

Snoring is a grunting sound emitted during sleep.  It is often associated with sleep apnea, a blocked airway.

The most common cause of this, in children, is an enlargement of the tonsils and adenoids.  The tonsils are located at the base of the tongue and the adenoids in the back of the nose.

Tonsils and adenoids become enlarged as a result of viral infections linked to colds.  Bacterial infections (such as strep throat) may play a role as well.

What are the symptoms of snoring and sleep apnea?

Audible snoring is obvious. 

With apnea, the breathing is irregular, with pauses of more than a few seconds.  This usually happens during REM sleep when the body is most relaxed.  (REM sleep occurs in 90-120 minute cycles throughout the night.)

Other problems may include:

  • Restless sleep
  • Nightmares
  • Sweating and bed-wetting (enuresis)
  • During the daytime, sleep problems may manifest as
  • Fatigue
  • Headaches
  • Inattention
  • Hyperactivity
  • Crankiness

How are snoring and sleep apnea diagnosed?

Sleep Study.  After taking a full medical history and performing a comprehensive physical exam, we may order a sleep study. This test involves observation and video recording of the child during sleep.  A number of body functions are also monitored including heart rate and rhythm, chest movements and oxygen levels. Most often this study requires an overnight stay in a hospital and we encourage parents to be present with the child.

This test is especially important for children with neurologic problems, craniofacial abnormalities, or obesity. 

How are snoring and sleep apnea treated?

Careful Monitoring. 

Medications. A trial of antibiotics and nose spray may be recommended to see if the snoring and apnea improve or clear completely.

Surgery.  If the problem doesn’t clear entirely with medication, surgery is the next step.  This may involve full removal of the tonsils (tonsillectomy) and adenoids (adenoidectomy).

Your child’s doctor may also recommend a partial removal of the tonsils, referred to as tonsil shaving. The benefits of this surgery are reduced pain during the healing period, faster healing period, and a lower risk of postoperative bleeding. Acetaminophen (Tylenol) or ibuprofen (Motrin, Advil) are most commonly prescribed for pain after a partial tonsillectomy. Most children will have complete resolution of the sleep symptoms and apnea in the 2-3 week period after surgery.