What does this mean?
Snoring is the sound of a narrowed passage vibrating as air goes through it. In a child that passage is already narrow, and the adenoids and tonsils reach their largest size relative to the space around them during the pre-school years. Snoring for a few nights with a cold is common. Snoring that carries on most nights of the week while your child is otherwise well is a different question.
What sets a child apart from an adult shows up during the day. In an adult a breathing problem in sleep most often looks like daytime drowsiness; in a child it can be the other way round, that is, not being able to sit still, losing their temper quickly and not being able to concentrate in class. The thought that 'they are never sleepy during the day, so there cannot be anything wrong' is misleading for this reason. Sweating at night, moving about the bed constantly, sleeping with the head tipped back, and bedwetting coming back after it had stopped are all part of the same set of questions.
When mouth breathing goes on over years, the growth of the upper jaw can be affected by it. The tongue normally rests against the palate and supports the upper jaw from the inside; when the mouth stays open all the time that support lessens, the palate can stay narrow and high, the front teeth can tip forward, and because the lips do not meet, the gums at the front dry out and become inflamed easily. There are more options for widening the upper jaw while growth is still going on; once growth has finished, the options narrow. This is why timing matters more in a child than in an adult.
Behind snoring in a child there is most often a blockage in the nose and in the passage behind it, and sometimes a narrow jaw; the two can also occur together. The headings below are looked at together at an assessment.
Likely causes
What helps at home?
- Take a short video while your child is asleep, with the face and the chest in shot. Whether the sound carries on all night, whether there are pauses and whether the chest is drawing in are the details the clinician will look at.
- Do not put snoring off with 'they will grow out of it'; the pre-school and primary school years are when both the size of the adenoids and the growth of the upper jaw change most.
- Do not give your child a spray, drops or an allergy medicine for a blocked nose on your own judgement; which one is used and for how long is a decision for the doctor, and some can make the blockage worse when they are used for a long time.
- Keeping the home smoke-free and the bedroom free of dust can reduce the sound; these changes do not remove the cause, and should not be treated as a reason to put the assessment off.
- If you have seen your child's breathing stop in their sleep, or they startle and gasp in a deep breath
- If the chest or the area under the ribs draws in while they sleep, or they cannot breathe without tipping their head back
- If you have noticed a blue tinge to the lips or the face; that needs emergency assessment the same day
- If they cannot breathe through their nose at all during the day, their mouth is open all the time and their voice sounds nasal
- If bedwetting has come back after it had stopped, growth in height and weight has fallen behind what is expected, or problems with attention and behaviour have started at school
Frequently asked questions
- Is snoring normal in a child?
- Snoring for a few nights during a cold or an upper respiratory infection is common and usually clears up along with the illness. Snoring that carries on most nights of the week while your child is otherwise well, with the sound not letting up all night, is not what is expected. What is needed in that picture is not waiting, but asking for the nose and the passage behind it to be assessed.
- If the adenoids are taken out, will the narrow jaw correct itself too?
- These are two matters that are assessed separately. Once the airway through the nose is opened up, mouth breathing lessens in most children; but a narrow, high palate that has taken years to form is not always expected to correct itself. The decision about surgery belongs to an ear, nose and throat specialist; the decision about the width of the jaw is the field of orthodontics. The order and the timing of the two assessments are set according to your child's age and findings.
- What age should I wait for before seeing a dentist about it?
- If there is snoring and sleeping with the mouth open, there is no need to wait for a particular age; the shape of the palate and the width of the jaws can be assessed while the baby teeth are still in. The general advice for an orthodontic assessment is around seven years old, because the first permanent molars and the front teeth come through at that stage. If there are symptoms to do with the airway, there is no need to wait for that age.
This content is for general information and does not replace an in-person examination. Symptoms overlap between conditions, and a diagnosis can only be made clinically.