There are a number of reasons why children snore but the most common health problem in children that causes snoring is enlarged tonsils and adenoids.
The tonsils lie at the top of the throat (pharynx) and are a useful part of the body as they help to defend against infection.
Tonsillitis occurs as the result of a viral or bacterial infection. It is much more common in children than adults owing to the size of the tonsils in children – they actually shrink substantially as the child grows older.
The symptoms of tonsillitis are a sore throat and difficulty in swallowing. An inspection of the back of the throat will reveal enlarged tonsils covered by a white film. Earache and enlarged lymph nodes in the neck are also symptoms associated with tonsillitis.
When tonsils become infected they enlarge and bearing in mind they are already fairly large structures in children further enlargement can cause significant breathing problems and snoring.
Children who have tonsillitis often have enlarged adenoids too. The adenoids are located at the back of the nasal cavity and, like the tonsils, consist of lymphatic tissue that forms part of the body’s defences against infection.
In most children with enlarged adenoids, symptoms are mild and appear over time. The symptoms include mouth breathing and snoring during sleep, a nasal sounding voice and a persistently blocked or runny nose.
The difficulty in breathing and the associated snoring may make it difficult for affected children to sleep which leads to daytime tiredness, irritability and poor concentration at school.
Enlarged adenoids can cause a partial blockage of the eustachian tubes connecting the throat to the ear which in turn leads to recurrent ear infections and in older children they can also block the channels from the sinus cavities causing sinusitis.
Other than offering anti-biotics to combat infection there is little that can be done to treat enlarged tonsils and adenoids. It is important that measures are taken to bring down body temperature in the child and to ensure they have plenty of fluid. Paracetamol may be given to bring down a fever and ease pain – aspirin should never be offered to children under twelve years of age as it has been linked with Reye’s syndrome (inflammation of the brain and liver).
If enlarged tonsils are causing a child to miss school regularly because of repeated bouts of tonsillitis or if enlarged adenoids and the associated snoring are disrupting sleep and causing recurrent middle ear infections, surgical removal will almost certainly be suggested. Although this procedure is nowhere near as popular as it was some 30 years ago, it is still conducted.
A tonsillectomy and adenoidectomy are usually conducted at the same time, under general anaesthetic. Usually only an overnight stay is required in hospital although a full recovery will take approximately two weeks.
Snoring in children should be investigated to determine the underlying cause. It may be enlarged tonsils or adenoids or it could be that the child has nasal polyps or, rarely, some form of tumour. Snoring is not something to be accepted as part of childhood – it is usually indicative of some other health condition.
