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Is it normal for my child to snore?

April 24th, 2014 11:15 am by Tim Martin, D.D.S.

Is it normal for my child to snore?

It is not normal for a person of any age to snore. As with adults, the question is whether the child is simply snoring or do they have sleep apnea. Let's talk about sleep problems in children in general before we decide what to do about the snoring.

There is a significant difference in sleep patterns between children and adults. Newborns sleep repetitively and randomly throughout the 24-hour day. Monophasic sleep, occurring all at one time, generally at night, develops during early childhood between the ages of 3 and 5 when napping ceases. The daily duration of sleep decreases from newborn infants, in whom sleep occupies 70 percent of a 24-hour day, to adults whose sleep averages 25 percent to 35 percent of a 24-hour day. Generally, the ability to sleep through the night develops at 6 to 9 months. 

Aggregate hours of sleep per day gradually decrease throughout childhood, averaging 16 to 19 hours in newborn to 2 months, 12 to 16 hours in infants, (2 to 12 months), 11 to 12 hours in toddlers (1 to 3 years), 10 to 12 hours in preschool children (3 to 5 years), eight to 11 hours during pre-adolescence (5 to 14 years), and seven to nine hours in adolescence (14 to 18 years).

Do children suffer from insomnia? Yes, and it can be due to a variety of causes including:

* Acute stress or change in bedroom environment.

* Bedtime resistance, which generally starts with the development of independence during the toddler years (1 to 3 years).

* Colic, starting at 3 weeks of age and usually resolving by 3 to 4 months of age.

* Food allergy.

* Nighttime fears, such as anxiety about being left alone in the dark.

* Separation anxiety.

As parents, how can we help our children who have insomnia? As we train the child to sleep through the night, the following can be helpful:

* Maintain a constant bedtime.

* Restful nighttime activities.

* Age-appropriate bedtimes.

* Optimal bedroom environment.

* Appropriate use of transitional objects, such as a doll or blanket for sleep-onset problems.

* Placing a child in bed while drowsy but still awake to teach the child to fall asleep independently beginning at 2 to 4 months of age.

* Transitioning the infant to the final sleep environment (for example: to a crib in the infant's room) by the age of 3 months.

* Discontinuation of nighttime feedings in children 6 months or older

* Relaxing pre-bedtime activities, not computer games.

No hypnotic sleeping pill is currently approved by the FDA for use in children

Now that we have covered childhood sleeping patterns and insomnia, let's get back to the question of, should my child snore? Every child who snores should be screened for sleep apnea. A polysomnogram, or laboratory sleep study, is required to distinguish between snoring and sleep apnea.

Seven percent to 12 percent of children snore and one-third of those have sleep apnea diagnosed by a polysomnogram. Things to watch for in your child that may indicate sleep apnea are:

* Excessive daytime sleepiness.

* Unusual sleep postures (like a hyper-extended neck).

* Labored breathing at night.

* Cognitive or behavioral problems.

* Secondary bedwetting.

* Bedtime resistance.

* Problematic night waking.

Left untreated, sleep apnea can give rise to growth failure, developmental delay, behavioral problems, attention deficit, hyperactivity, aggressiveness, irritability, intellectual impairment, mood disorder, increased frequency of sleep walking or sleep terrors, and poor academic performance.

Obstructive sleep apnea is most common in pre-school age kids, which coincides with the age when tonsils and adenoids are the largest in relation to the airway size. The treatment of choice for most children with sleep apnea is removal of the tonsils and adenoids. It is effective in 75 to 100 percent of children with sleep apnea. It is important to make sure the surgery was effective in six to eight weeks after the surgery. Other treatments used if adenotonsillectomy isn't effective include rapid palatal expansion to make space for the tongue, aggressive weight loss if indicated, and even a CPAP.

So if your child snores, talk to your pediatrician, get the child tested and help prevent the problems associated with obstructive sleep apnea.

Timothy Martin, D.D.S., is board certified in dental sleep medicine and dedicates a portion of his practice to treating sleep apnea and snoring. He practices at Martin Dentistry with his son, Dr. Kevin Martin. E-mail questions to tmartin@martindentistry.net, visit www.martindentistry.net or call (423) 247-8172.

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