Many parents mention their child's snoring almost in passing, sometimes with a smile. It is often the most important part of the consultation. Children should not snore most nights, and when they do, it is worth asking why.
How common is snoring in children?
Around one in ten children snore on three or more nights a week. A smaller group, somewhere between one and five in every hundred, have obstructive sleep apnea, where the airway repeatedly narrows or closes during sleep. Snoring alone does not mean apnea, but it is the most common starting point.
Why children snore
- Enlarged tonsils and adenoids. The most common cause, particularly between two and eight years, when these tissues are largest relative to the airway.
- Allergic rhinitis. A blocked nose from dust mites, indoor allergens or dust exposure. This is very common in the UAE, where children spend long hours in air-conditioned rooms.
- Colds and viral infections. Temporary snoring that settles when the infection clears.
- Excess weight, which narrows the upper airway.
- Face and jaw shape, low muscle tone and certain genetic conditions.
Signs that snoring may be sleep apnea
During sleep:
- Pauses in breathing, followed by a gasp or snort
- Laboured breathing with the chest pulling in
- Restless sleep, unusual sleeping positions, often with the neck stretched back
- Heavy sweating at night, or new bedwetting
During the day:
- Mouth breathing and a nasal voice
- Difficulty waking, morning headaches
- Poor concentration, hyperactivity or irritability, sometimes mistaken for ADHD
- Falling behind at school, or poor growth in younger children
A useful thing to do at home
Record a two-minute video on your phone when your child is snoring at their worst, usually in the early morning hours, with their chest and face visible. It shows me far more than a description ever can.
Record a two-minute video on your phone when your child is snoring at their worst, usually in the early morning hours, with their chest and face visible. It shows me far more than a description ever can.
What assessment involves
- History and examination, including tonsils, nose, allergy signs, growth and blood pressure.
- Allergy assessment where nasal symptoms suggest it.
- A sleep study when the diagnosis is uncertain, when the child is young or has other medical conditions, or when surgery is being considered.
Treatment options
- Treating allergies with allergen reduction and nasal steroid sprays. This helps many children with mild symptoms.
- Tonsil and adenoid surgery for children with significant obstructive sleep apnea and enlarged tonsils or adenoids, through an ENT surgeon.
- Weight management where relevant.
- CPAP for children with persistent sleep apnea after surgery, or where surgery is not suitable.
- Watchful waiting with a planned review for children with snoring but a normal or mildly abnormal study.
Seek prompt medical review if your child has long pauses in breathing, turns blue during sleep, is struggling to breathe, or snores and has a neuromuscular condition, Down syndrome or a heart condition.
For a fuller explanation of the condition itself, read sleep apnea in children.
Clinical references
- Marcus CL, Brooks LJ, Draper KA, et al. Diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics 2012;130:576–584. View source
- Kaditis AG, Alonso Alvarez ML, Boudewyns A, et al. Obstructive sleep disordered breathing in 2- to 18-year-old children: diagnosis and management. Eur Respir J 2016;47:69–94. View source
- Marcus CL, Moore RH, Rosen CL, et al. A randomized trial of adenotonsillectomy for childhood sleep apnea. N Engl J Med 2013;368:2366–2376. View source
Frequently asked questions
Is it normal for a child to snore every night?
No. Occasional snoring with a cold is common, but snoring on three or more nights a week should be assessed, particularly if there are pauses in breathing, restless sleep or daytime symptoms.
What causes snoring in children?
The most common cause is enlarged tonsils and adenoids. Allergic nasal congestion, colds, excess weight, face and jaw shape and low muscle tone can also contribute.
Does snoring in children affect behavior?
It can. Disrupted sleep from obstructive sleep apnea is linked with poor concentration, hyperactivity, irritability and learning difficulties, which often improve after treatment.
Will my child need surgery for snoring?
Not always. Children with significant sleep apnea and enlarged tonsils or adenoids often benefit from surgery, while milder cases may improve with allergy treatment or careful monitoring.
About this information. This article is for general education and does not replace an assessment by a qualified doctor who has examined your child. If you are worried about your child’s breathing right now, contact your child’s doctor, go to the nearest emergency department, or call 998.
