Children Who Snore Need to Be Evaluated for Sleep Apnea

Based on a review of over 3,000 research studies, the American Academy of Pediatrics recently published new guidelines recommending that children should be screened for snoring every time they visit their pediatrician.

This is a groundbreaking step for pediatric sleep medicine. It's a big change. It's important, because it tells pediatricians that sleep disorders in children are serious. It tells parents that snoring isn't just a cute thing where a child is doing something adults do.

The idea that a snoring adult might indicate a more serious problem is becoming more widely understood. But even in children, snoring can be caused by sleep apnea, which can in turn cause major health and behavioral problems. Someone with sleep apnea experiences brief but frequent interruptions in breathing during sleep. Children with sleep apnea are often irritable and sleepy during the day, wake up with headaches and have trouble learning, focusing and retaining information.

Parents should make it a point to watch and listen to their children while they are sleeping. They need to pay attention to snoring just as they would pay attention to height and weight, and bring it up with their pediatrician.

Snoring typically has been ignored by pediatricians, which is one reason sleep disorders are under-diagnosed in children. Between 1.2 to 5.7 percent of American children suffer from sleep apnea. But the percentage that is diagnosed and receives treatment is much lower. For every five children diagnosed with asthma, at least one should be diagnosed with sleep apnea.

The new guidelines are intended to close that gap by having pediatricians ask children and their parents about snoring just as they would ask about immunizations, exercise habits or eating. If the answer is yes, the child does snore, the pediatrician should go further, with a detailed history and examination.

If signs of sleep apnea are found, the next step should be a sleep study. Depending on the results, further treatment might include nasal sprays, tonsillectomy, or sleeping with a CPAP (continuous positive airway pressure) machine, which keeps airways open by pumping air through a face mask over the mouth and nose. In addition to any other treatments, weight loss will be recommended if the child is overweight or obese.