20.07.2014
Children with nasal allergies (also known as allergic rhinitis or hayfever) often have swollen nasal passages, that frequently contribute to persistent snoring.
In younger children, enlarged adenoids are one of the primary factors contributing to persistent childhood snoring.
Although the answer to this question is very complicated, snoring frequently leads to disruption of sleep.
Studies have shown that children with persistent snoring are up to 5 times more likely to have daytime sleepiness and up to 4 times more likely to have symptoms of attention deficit. If any of these signs are present with snoring, your child may have a medical condition called obstructive sleep apnea. Assessing for any abnormalities in daytime functioning is very important in determining how aggressively the snoring should be treated. Children with snoring will frequently have swollen nasal passages that can be seen during the examination. Children with frequent snoring and issues with daytime functioning should be considered for anovernight sleep study (polysomnography).
Childhood snoring treatment should be customized depending on the medical history and findings on physical examination. Mild snoring without significant impairment in daytime functioning and no evidence of obstructive sleep apnea. Identifying and treating nasal allergies s an important step for children with mild snoring and none of the signs of sleep disruption listed above.


When children have snoring that is associated with impairment in daytime functioning and evidence of obstructive sleep apnea, more aggressive treatment should be considered.
Removal of the adenoids and tonsils should be considered the primary treatment option in this situation.
Identifying and treating nasal allergies is also an important step for children in this category. Children with significant snoring are also more likely to have orthodontic issues that can lead to nasal congestion, snoring, and obstructive sleep apnea.
Adenoids can grow in size as a consequence of recurrent upper respiratory infections and nasal allergies. Often times, treating a child’s snoring can lead to significant improvement in a child’s energy level, behavioral problems, and school performance.
A recent study showed that regularly snoring children with a history of asthma had more frequent and severe asthma symptoms than children that did not snore. The sleep study will monitor the brain function (EEG), heart rhythm (EKG), oxygen levels, muscle movements, and snoring levels.
Coordination of care between the pediatrician, allergist, and ENT (ear, nose and throat) surgeon is important to tailor care appropriately.
Many children with persistent snoring and mouthbreathing may have a narrow jaw structure and a recessed lower jaw (lower jaw set farther back). The peak incidence of snoring typically occurs at 6 year of age, corresponding with the peak growth of adenoid tissue.


Rotskoff has been diagnosing and treating childhood allergies in Chicago since completing his fellowship in Allergy and Immunology at Children’s Memorial Hospital and Northwestern Memorial Hospital in 2003. It should be mentioned that there are other reasons to consider having the adenoids and tonsils removed in addition to snoring and obstructive sleep apnea. As the child’s airway develops beyond this age, the size of the airway can increase relative to the size of the tonsils and adenoids- resulting in diminished snoring.
An allergist can perform skin testing to determine whether your child has significant environmental allergies contributing to snoring. Whether to treat snoring aggressively must be determined by considering the risks and benefits of treatment. Allergy shots and allergy drops (under the tongue) can also be very helpful in treating environmental allergies. The presence of obstructive sleep apnea would warrant more aggressive treatment of the snoring. In combination, enlarged adenoids and tonsils can lead to significant snoring, mouth breathing, and even airway obstruction (referred to as obstructive sleep apnea).



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