(CMR) Parents usually think it is harmless when they hear their children snoring and consider it a sign that they are sleeping soundly; however, one doctor said it could be a sign that they are having breathing problems.
Parents advisor Dr. Judith Owens, director of sleep medicine at Boston Children's Hospital, said, “The louder the snoring is, the more concerned we are. If your child snores three times a week, even without any other symptoms, they need an evaluation.”
According to parents.com, snoring is a signal of a breathing problem that can stem from multiple causes: the length of a child's jaw and width of their palate; the shape of the skull; or congestion in the nose and upper airway, which is commonly due to oversize tonsils and adenoids. Sometimes, kids experience a combination of factors.
Parents.com writer Katherine Reynolds Lewis explained that when kids lie down, and their throat muscles relax, the airway narrows at night. Of particular concern are gasping, snorting, and choking noises or working hard to breathe. These are signs of sleep apnea when breathing is repeatedly blocked or partially blocked for a split second and then starts again.
If you notice any of the issues, Lewis suggests you discuss them with your child's pediatrician and ask for a referral to a specialist, whether it's a sleep expert; an ear, nose, and throat doctor, or a dental professional familiar with the sleep-mouth connection.
Lewis pointed out that the clue to a possible sleep problem can usually be seen in your child's face. In profile, the chin should align with the nose and mouth. Kids with a narrow face, a recessive chin, or crowded, crooked teeth—even baby teeth—are more likely to have a short jaw, a narrow palate, and a small airway. The floor of the nasal airway is also the roof of the mouth, known as the palate. Since they are physically connected, the width of the palate influences the width of the airway. Doctors can look for features on a checklist to identify kids at higher risk.
What healthy sleep looks like
According to Lewis, good sleepers keep their lips closed and breathe comfortably through their nose. If a child's mouth routinely falls open during sleep, it could be a sign that their jaws are misaligned (the upper teeth should fit slightly over the lower teeth). Or it could be a heads-up that your child has chronic nasal congestion.
Whatever the cause, the result is the same: Air dries out the throat and can lead to infections and inflammation. Kids also miss out on the benefit of tiny hairs and mucous membranes in the nose that clean the inhaled air and body temperature that warms and humidifies the air before it reaches the throat. The air flowing through the nasal sinuses creates nitric oxide, an essential gas for brain development. Over time, the nasal airway and jaws shrink, making kids rely more on mouth breathing. However, there are steps that can help keep their jaws in good shape:
Retire the binky: All kids should forgo the pacifier after infancy, advises Madeleine Goodman, D.M.D., of Harmony Pediatric Dentistry & Orthodontics, in Bethesda, Maryland. “When a child has a foreign object in their mouth for a third to half the time they're awake, it changes the shape of the jaws.” Sucking can cause kids to overuse cheek muscles; that puts pressure on jaws, narrowing them. To be sure, pacifier use is only one contributing factor, and not all Binky addicts will end up with misaligned jaws.
Reduce their nighttime exposure to allergens: Wash sheets at least once a week in water that's 130°F or higher to kill dust mites—you may want to do so even more often if your child is highly allergic. An air purifier will help remove pollen, dust, and other irritants from the room.
Give their jaws a workout: Serve toddlers solid food, like chicken and crunchy fruits, to strengthen their jaws. Limit food pouches since they encourage sucking, which doctors say can distort the shape of the jaws.
If you're concerned about your child's symptoms, you can start by asking your child's pediatrician or dentist if they have experience treating sleep-disordered breathing. Kids with a normal-width palate and jaw may have allergies, asthma, enlarged tonsils, or swollen adenoids. Find your way to the right specialist to guide you through treatment options. That could be an allergist, a dentist, an orthodontist, or a sleep specialist, who is a doctor from several related fields, such as pulmonology, otolaryngology, or neurology.
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