The Impact of Childhood Snoring on Health and Development

Imagine a persistent cell phone ringing, waking up your child every hour, and preventing them from delving into a deep, restorative sleep. That's the startling parallel to what snoring can do, potentially leading to a drop in their IQ by 8-10 points (1).

The quality of your child's sleep during their early years has a profound impact on their physical health, mental well-being, and even their IQ. In this article, we're here to equip you with the knowledge you need to recognize the signs and take action. We want to ensure that your child doesn't fall behind but instead thrives by getting the restorative sleep they deserve.

Sleep is a fundamental pillar of childhood well-being, with a profound impact on immune system strength, cognitive development, and productivity. Its significance is most pronounced during the initial three years of life, a period of rapid brain growth. Within the first year, the brain doubles in size, and by age three, it's already achieved 80% of its adult volume (2).

However, amidst the quest for improved sleep quality, one critical aspect often goes unnoticed: childhood snoring and its connection to airway problems and breathing difficulties. These issues hinder children from reaching the essential deep sleep stages required for restoration, sustained focus, optimal concentration, and daytime functionality.

The presence of snoring during a child's sleep should raise a red flag, as it may signify resistance to proper airflow. Snoring is also a prominent indicator of childhood Obstructive Sleep Apnea (OSA), characterized by recurring throat obstructions lasting ten seconds or more during sleep. Astonishingly, OSA affects up to 5% of children, placing it on par with the prevalence of asthma. In an ideal scenario, a healthy sleeping child is quiet, still, breathes through their nose, and keeps their mouth closed. Addressing childhood snoring is essential to ensure their well-being and development.

 Several factors can contribute to childhood snoring:

• Large or swollen tonsils and adenoids
• Obesity
• Congestion and allergies
• Asthma
• Anatomic characteristics affecting airway flow
• Exposure to environmental tobacco smoke (ETS)
• Contaminated air and low air quality
• Shorter duration of breastfeeding (under 3 months)

Childhood snoring can cast a shadow over a child's well-being, leaving them unrefreshed upon waking, battling unexplained tiredness, and even mimicking the symptoms of ADHD. They may appear more "wired than tired," a perplexing state that often goes unnoticed. What's more, the repercussions of childhood snoring can stretch into adulthood, paving the way for chronic health conditions.

Did you know that 30-50% of individuals with hypertension also suffer from Obstructive Sleep Apnea (OSA)? This percentage surges to a staggering 95% in cases of refractory hypertension, where blood pressure remains uncontrolled despite three or more medications (4). However, the impact of sleep-related issues goes beyond OSA, affecting a broad spectrum of individuals, including children, lean individuals, and pre-menopausal women.

Even without OSA, these groups can experience airflow restriction during snoring, leading to chronic stress and fragmented sleep. This often manifests as symptoms such as teeth grinding, tension headaches, anxiety, insomnia, or irritable bowel syndrome-like symptoms. In essence, snoring disrupts sleep and prevents the recovery processes that are essential for restorative sleep.

In Dr. Salazar's practice, he encounters countless individuals who, much like you or me, may not initially realize the broader implications of snoring. It's a scenario he witnesses all too often. Many come seeking solutions for frequent awakenings during sleep, persistent tension headaches, or unexplained irritability, unaware of the link to their snoring. It's here that Dr. Salazar's expertise shines as he unravels the intricate web of connections between snoring, health, and well-being, guiding his patients toward healthier, more restful lives.

What's alarming is that even so-called "primary snoring" (snoring without reduced oxygenation) has concerning consequences. It has been linked to grey matter losses in children and an increased risk of behavioral problems. In adults, snoring stands as an independent risk factor for stroke, which is the fifth leading cause of death in the USA (5).

The vibrations produced by snoring can dislodge arterial plaque in the carotid artery of the neck. When this plaque reaches the brain and blocks a vessel, it can disrupt blood flow, leading to one of the most common ways strokes occur. Recognizing the broader impact of snoring beyond just OSA is crucial for addressing potential health risks and promoting better sleep quality for all.

The impact of childhood snoring reaches far beyond physical health, seeping into the realm of cognition, behavior, and academic performance.

Children who snore may find themselves struggling to concentrate, grapple with memory issues, and face academic setbacks. Staying focused in class becomes a herculean task, leading to lower grades and diminished cognitive prowess. The daytime drowsiness that accompanies snoring hampers their participation in extracurricular activities, social interactions, and their ability to fully engage in the learning process.

Moreover, research has revealed that children with untreated sleep-disordered breathing conditions, like obstructive sleep apnea (OSA), are more likely to exhibit behavioral problems, including hyperactivity and aggression. These behavioral challenges can further undermine academic success and overall well-being.

As parents and caregivers, understanding and addressing childhood snoring can be transformative. It can unlock a child's full potential and pave the way for success in every facet of their life, from the classroom to their social interactions, setting them on a path to a brighter future.

Recognizing the signs and symptoms of sleep-disordered breathing in children is crucial for early intervention and treatment. Some common signs include:

• loud snoring or audible breathing
• restless sleep
• mouth breathing
• excessive daytime sleepiness
• sweating
• teeth grinding
• night terrors
• bedwetting
• signs of ADHD

 It's important to note that not all children who snore have a sleep disorder, but persistent snoring should not be ignored.

If you suspect that your child may have sleep-disordered breathing, it is recommended to consult with a healthcare professional. They can conduct a thorough evaluation and may refer your child to a sleep specialist for further diagnosis. Diagnostic tools such as a sleep study, also known as a polysomnogram, can provide valuable insights into your child's sleep patterns and help determine the appropriate course of treatment.

Treating childhood snoring involves a multi-faceted approach that addresses the underlying causes and improves sleep quality. The treatment options may vary depending on the severity of the snoring and the presence of any associated sleep-disordered breathing conditions.

One common treatment option is the removal of enlarged tonsils and adenoids through a surgical procedure called adenotonsillectomy. This procedure can significantly improve airflow and reduce snoring in children with obstructive sleep apnea or enlarged tonsils and adenoids. Other interventions may include continuous positive airway pressure (CPAP) therapy, which involves wearing a mask during sleep that delivers pressurized air to keep the airway open.

In cases where jaw and airway development contribute to snoring, orthodontic interventions may be recommended. These can range from using orthodontic appliances to expand the jaw to orthognathic surgery, which involves repositioning the jaw to improve airway function.

Indeed, addressing childhood snoring often requires a multi-faceted approach. Optimal solutions may involve consultation with Ear, Nose, and Throat specialists, Primary Physicians, and Dental Sleep Specialists. Collaborative efforts pave the way for the best outcomes in tackling this complex issue.

Childhood snoring can have a profound impact on a child's health and development. It is important to recognize the signs and symptoms of snoring and take proactive steps to address them. By understanding the causes, risks, and potential consequences of childhood snoring, you can make informed decisions about treatment options and prevention strategies.

Consulting with a healthcare professional is crucial for an accurate diagnosis and appropriate treatment plan tailored to your child's needs. Together, we can ensure that your child gets the quality sleep they deserve, setting them up for a healthier and brighter future. Don't let childhood snoring go unnoticed; take action today for a better tomorrow.

1. Easton, J. (2017, March 17). Untreated sleep apnea in children can harm brain cells tied to cognition and mood. University of Chicago Medicine. https://www.uchicagomedicine.org/forefront/pediatrics-articles/untreated-sleep-apnea-in-children-can-harm-brain-cells-tied-to-cognition-and-mood

   
   

2. Urban Child Institute. (n.d.). Baby's brain begins now: Conception to age 3. http://www.urbanchildinstitute.org/why-0-3/baby-and-brain

   
   

3. Lurie Children's Hospital. (2022, March 7). Common snoring in children and toddlers: When to worry. https://www.luriechildrens.org/en/blog/snoring-in-children-toddlers-when-to-worry/

   
   

4. Muxfeldt, E. S. (2018, August 6). Prevalence of Obstructive Sleep Apnea in Refractory Hypertension. Hypertension, 72, 592–593. https://doi.org/10.1161/HYPERTENSIONAHA.118.11275

   
   
5. Rahangdale, S., Campana, L., & Malhotra, A. (2008). Not So Good Vibrations. Sleep, 31(9), 1204–1205. PMID: 18788644. PMCID: PMC2542974. URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2542974/