When snoring matters
Light snoring during a cold or hay fever, which stops when the nose clears, is not usually a concern. Snoring that happens most nights, for weeks or months, deserves a closer look.
Signs that snoring is affecting your child’s breathing include pauses in breathing followed by a snort or gasp; laboured breathing, with the chest pulling in; very restless sleep, or sleeping in unusual positions such as with the neck stretched back; breathing through the mouth all the time; heavy sweating at night; and wetting the bed again after being dry.
How it shows during the day
Children with sleep apnoea are often not sleepy in the way adults are. Instead they may be irritable or overactive, find it hard to concentrate, or struggle at school, and this can be mistaken for a behaviour problem. Some wake tired, have morning headaches, eat poorly, or grow more slowly than expected.
Snoring alone is not a reason for alarm. These signs are a reason to have your child assessed.
Why it happens
In young children the usual cause is large tonsils and adenoids. The adenoids sit at the back of the nose, where they cannot be seen through the mouth. Together with the tonsils, they can fill much of a small child’s airway, and they tend to be largest in the preschool and early school years.
A blocked nose from allergy, being overweight, and some conditions that affect the face, the jaw or muscle tone also play a part. Large adenoids can block the Eustachian tubes too, so some children who snore also have glue ear and dull hearing.
What happens at the appointment
Dr Kana asks about your child’s sleep, breathing, behaviour, schooling and general health. It helps a great deal to bring a short video of your child asleep, recorded on a phone, especially of any pauses or noisy breathing. He examines the nose, throat and ears, and a hearing test can usually be done by the audiologists in the same rooms.
Many children can be assessed from the history, the examination and the video. A sleep study is advised for some, for example when the picture is unclear, when the child is very young, or when there are other medical conditions.
Treatment
If symptoms are mild, a period of watching, sometimes with a steroid nasal spray or treatment for allergy, may be enough, and some children improve as they grow.
When the tonsils and adenoids are large and the symptoms are significant, removing them is the usual treatment. Dr Kana will explain what the operation involves, how recovery goes and what the risks are, so that you can decide together. Parents often notice quieter sleep soon after surgery, and changes in mood and concentration over the following weeks, although the result is not the same for every child.
Children usually go home the same day or the next morning. The throat is sore for about ten days, and most children need about a week off school. Regular pain relief, plenty of fluids and soft food help. Any bleeding from the mouth or nose after tonsil surgery, even a small amount, needs prompt attention at an emergency unit.
Where and when to seek help
Children can be seen at either rooms. Netcare Mulbarton Hospital has specialised care for children and is convenient for families in the south of Johannesburg.
If your child is struggling to breathe, looks blue or grey around the lips, or cannot be woken properly, go to the nearest emergency unit straight away; in South Africa, dial 112 from a mobile phone.
This page is general information, not medical advice for your situation.
