Children’s Snoring and Sleep Apnoea

Assessment and treatment of sleep-disordered breathing in children

Is snoring normal in children?

Occasional snoring is common. Snoring most nights, especially with pauses in breathing, gasps or restless sleep, can be a sign of obstructive sleep-disordered breathing or obstructive sleep apnoea (OSA), which affects about 1–6% of children. The most common cause is enlarged tonsils and adenoids.

Signs to look for

Loud snoring most nights, pauses or gasps
Restless sleep, sweating, sleeping with the neck stretched back
Bedwetting returning after being dry
Daytime tiredness, irritability, hyperactivity or poor attention
Mouth breathing, and sometimes poor growth

Assessment

Assessment starts with a history and examination. Questionnaires such as the OSA-18 help track symptoms, and an overnight sleep study is recommended for some children – for example those with Down syndrome, excess weight, craniofacial or neuromuscular conditions, or when the diagnosis is uncertain. Dr Reddy is a member of the Sleep Medicine multidisciplinary team at Sydney Children’s Hospital.

Treatment options

Watchful waiting for mild symptoms
Nasal steroid spray and/or montelukast, particularly with allergies
Adenotonsillectomy – the most effective treatment when tonsils and adenoids are enlarged. See tonsillectomy and adenoidectomy
Weight management where relevant
CPAP when OSA continues after surgery or surgery is not suitable

In large randomised trials, adenotonsillectomy improved symptoms, behaviour and quality of life compared with watchful waiting, and normalised breathing on sleep studies in about 8 in 10 children.

Frequently asked questions

Will my child grow out of it? Mild symptoms sometimes improve with time, but moderate or severe OSA usually needs treatment.

Does my child need a sleep study? Not always. It depends on age, symptoms and other health conditions.

Will my child stay overnight after surgery? Children under 3, those with severe OSA and those with other medical conditions are usually monitored overnight.

Information for parents

Download When children snore: why it matters (PDF) and the OSA-18 sleep questionnaire (PDF) to complete before your appointment.

Where Dr Reddy sees patients

Dr Reddy sees adults and children at Macarthur ENT in Gregory Hills and Campbelltown, and at My-ENT in the Sydney CBD (Macquarie Street). He operates at Sydney Children’s Hospital, Randwick (public), and Camden Surgical, Sydney Southwest Private and Prince of Wales Private hospitals (private).

Referral

GPs, paediatricians and other specialists can refer via HealthLink (Macarthur ENT EDI: macarent; My-ENT EDI: myentdr), email referrals@drrithvikreddy.com or use the online referral form. A current referral from a GP or specialist is needed for a Medicare rebate.

Dr Rithvik Reddy

Expert ENT services for adults and children.

Contact for appointments

Referring doctors can email referrals@drrithvikreddy.com to make appointment

Macarthur ENT

Shop 2101, Level 2, 31A Lasso Rd, Gregory Hills NSW 2557

Suite 102, Building B, Level 1, 4 Hyde Parade, Campbelltown NSW 2560

Phone (02) 4625 1682 · Fax (02) 4625 1032

Mon–Fri 8am–5pm

My-ENT, Sydney CBD

Suite 303, Level 3, BMA House, 135 Macquarie Street, Sydney NSW 2000

Phone (02) 9247 1762 · Fax (02) 9247 2141

Mon–Fri 8:30am–5pm