Sleep Disorders
Sleep Apnoea
Children, Adolescents & Parents
Parasomnias

Childhood Snoring and Sleep Apnoea

This is a fact sheet about Childhood Snoring and Sleep Apnoea. It's important to differentiate between snoring and more serious conditions like paediatric sleep apnoea.

Young girl asleep in bed.
Homedown arrow iconSleep disordersdown arrow iconChildhood Snoring and Sleep Apnoea
calendar icon
December 24, 2024
time, clock icon
min read

Summary

Things you should know about Childhood Snoring and Sleep Apnoea

  • A child who snores may have sleep apnoea, but not all children who snore will have sleep apnoea.
  • Sleep apnoea is a condition where people experience blockages or pauses to their breathing while asleep.
  • These events may happen many times per night.
  • These blockages can disturb sleep and oxygen levels which can result in problems during the day.
  • In children the most common cause is due to blockages or obstruction to the airway by tonsils and/or adenoid. This can be treated with surgery.

What is sleep apnoea?

Obstructive Sleep Apnoea is when a child stops breathing due to repeated blockages to their airway while they sleep. The child is trying to breathe and often will gasp or choke to open up their blocked airway.  These blockages are usually due the tonsils and adenoids obstructing the upper airway. They are most common during dream sleep when the airway muscles relax. A less common form of apnoea is called Central Sleep Apnoea which results from a problem with the way that the brain controls breathing.  In central sleep apnoea a child stops breathing and their chest stops moving.

How are snoring and sleep apnoea related?

A child with sleep apnea almost always snores and often sleep with their mouth open. They may struggle to breathe and have restless sleep. There are often breathing pauses which may end with a gasping or choking noise. Children may look like they are working hard to breathe with their chest sucking in and out. Sometimes a child may sleep in strange positions such as sleeping with their neck and head stretched back. They may sweat a lot when they sleep. In some cases they will wet the bed. In the morning they may wake up with a dry mouth and be tired despite an adequate amount of sleep overnight.

What are the symptoms of sleep apnoea during the day?

Because of the events during sleep, the child with sleep apnoea may have a number of problems during the day. Infants may feed poorly, fail to gain weight and be delayed developmentally. Older children may have problems with their behaviour, e.g. being hyperactive, aggressive, having trouble learning and/or not being able to focus well. Being sleepy during the day may lead to personality changes, not doing well at school and problems with how they get on with others. A child with sleep apnoea may lag behind in many areas of development. They may get frustrated and depressed. In the long term, if sleep apnoea is not treated it may cause heart problems and high blood pressure.

How does this affect the child’s family?

Sleep apnoea in a child may be very worrying for the family. Possible behavioural problems, combined with potential problems at school, can be stressful for the whole family.

What is the cause of sleep apnea?

In a child, the most common cause of snoring and sleep apnoea is blockage of the airway by tonsils and adenoids. Obesity can play a part as well. Other risk factors are the shape of the skull and the size of the tongue e.g. a child with Down syndrome has a larger tongue that may block the airway. In children with a small or receding jaw, sleep apnoea is more common.  Other high risk groups include children who have had cleft palate surgery, as well as children with neurological problems such as cerebral palsy and muscle weakness.

How is sleep apnoea diagnosed?

A doctor might suspect this if they see large tonsils and adenoids and certain symptoms are reported. This could include the child snoring, feeling sleepy and possibly having episodes of breathing obstruction. However the best way to be really sure about the problem and its severity is with a Sleep Study. The study is conducted in a special area of the hospital. The child has some sensors and fine wires attached to the skin, which are connected to a computer which measures sleep, breathing and oxygen levels. Studies are generally done  at night but occasionally  in the daytime nap  in babies. None of the measurements are uncomfortable or painful and children usually manage to sleep. Parents generally stay with the child.

How is sleep apnoea treated?

If a child’s sleep apnoea is thought to be due to the size of their tonsils or adenoids, the first thing that is normally done is to take them out. In many cases this will cure the sleep apnoea. Sometimes conservative treatment with nasal steroid sprays to shrink the adenoids may be trialed especially if the child has very small tonsils. If surgery is not an option, or despite undergoing removal of tonsils and adenoids there is ongoing obstructive sleep apnoea then CPAP- Continuous Positive Airway Pressure maybe an option. This involves the delivery of room air at a low pressure from a machine via a tube connected to a  mask on the face. It only needs to be used at night and the treatment starts working straight away. With the right support, most children do well with CPAP. If the sleep apnea is contributed to by a child’s weight, then weight loss programs are advised .

Can it be treated with drugs?

To date there is no effective medication for treating sleep apnoea although a number have been tried. Other remedies have been marketed, but none has been shown to be effective. Nasal steroid sprays or combination nasal steroid and anti-histamine nasal sprays can be an option in some children, especially those who suffer from allergies.

What about sleep habits?

Although sleep apnoea usually requires a treatment such as already outlined, it is also very important that the child has good sleep habits. A regular time to go to bed and to wake up should be set. Before bed, the child should be away from anything that stimulates them (e.g. games, TV).The bedroom should be quiet and dark. In the afternoon and evening you should avoid giving caffeine drinks (including cola and hot chocolate) to your child. See Sleep Hygiene: Good Sleep Habits for more on this.

What other sleep problems can a child suffer from?

Although snoring and sleep apnoea are common conditions, children may also suffer from other sleep disorders. Parasomnias such as Sleep Walking and Sleep Terrors are common in childhood and can be distressing to the child and parent. Underlying medical conditions such as epilepsy and asthma may also cause sleeping problems. See these pages for more;  Sleep Problems and Sleep Disorders in School Aged Children and Behavioural Sleep Problems in School Aged Children.

Should I seek help?

If you are worried about snoring or sleep apnoea in your child, you should speak with your GP. A referral will be needed to see a sleep physician.

Download a PDF of this Fact Sheet

Other useful links: