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When a child occasionally snores, most parents don’t consider it alarming and it is often described as cute. A common cold almost always causes some nasal congestion, and any resultant reduction of efficiency in breathing can cause snoring. While it is true that all snoring is not cause for concern, chronic snoring may indicate a sleep disorder that can in turn have serious health consequences. In visits to the pediatrician, parents may not think it important to report chronic snoring, and pediatricians may not routinely ask about it unless there are other signs of adenotonsilitis or obstructive sleep apnea.
Many parents may not be aware of how breathing problems in sleep indicated by snoring can be associated with later neurocognitive, cardiovascular, growth, and behavior problems. A study by Urschitz and colleagues (2004) found that habitual snoring in a large sample of third-grade children was significantly associated with hyperactive and inattentive behavior, conduct problems, emotional adjustment, and peer problems. In a study of neurocognitive outcomes, Hunter and colleagues (2016) studied a large sample of snoring and nonsnoring children ages 5 to 7 with polysomnography and tests of intellectual, attention, memory, language, and executive function development. Comparing children with different degrees of apnea-hypopnea index (AHI), they found a dose-related relationship with those having higher AHIs also having more severe problems. For many children, adenotonsillectomy can reduce or eliminate sleep-disordered breathing. Moreover, children who have the surgery have been shown to improve their performance on neurocognitive measures.
Parents should monitor their child’s snoring, and if it happens regularly, they should discuss it with a pediatrician. Referral to an ear, nose, and throat specialist or a sleep specialist may be recommended.
References
Chawla, J., & Waters, K. A. (2015). Snoring in children. Journal of paediatrics and child health, 51(9), 847-851
Friedman, B. C., Hendeles-Amitai, A., Kozminsky, E., Leiberman, A., Friger, M., Tarasiuk, A., & Tal, A. (2003). Adenotonsillectomy improves neurocognitive function in children with obstructive sleep apnea syndrome. Sleep, 26(8), 999-1005.
Hunter, S. J., Gozal, D., Smith, D. L., Philby, M. F., Kaylegian, J., & Kheirandish-Gozal, L. (2016). Effect of sleep-disordered breathing severity on cognitive performance measures in a large community cohort of young school-aged children. American journal of respiratory and critical care medicine, 194(6), 739-747.
Montgomery-Downs, H. E., O'Brien, L. M., Holbrook, C. R., & Gozal, D. (2004). Snoring and sleep-disordered breathing in young children: subjective and objective correlates. Sleep, 27(1), 87-94.
Urschitz, M. S., Eitner, S., Guenther, A., Eggebrecht, E., Wolff, J., Urschitz-Duprat, P. M., ... & Poets, C. F. (2004). Habitual snoring, intermittent hypoxia, and impaired behavior in primary school children. Pediatrics, 114(4), 1041-1048.
