• Obesity adds to the risk of snoring and apnea. If your child is obese, his weight must be managed along with his treatment.

• Advise your child to sleep on the side and avoid sleeping on the back. Some snore, or snore heavily, only when sleeping on the back.

The sound of snoring is caused by the vibration or flapping of the tissues lining the upper air passages. Snoring in most people is due to multiple factors, each playing some part in the snoring process:

• Large tonsils
• Relaxation of muscles causes the walls of the upper airway to fall together, causing them to vibrate.
• Swelling of the tissue in the walls (e.g. from anatomical or injury reasons) causes narrowing of the airway, and results in snoring.
• The tongue may fall back into the throat when sleeping on the back and contribute to the snoring.
• Nasal blockage such as nasal allergy or deformities of the nasal septum (the cartilage partition between the two sides of the nose) can cause poor nasal airflow and set the soft tissues of the palate and throat vibrating.

Large tonsils are the most common cause of snoring and sleep apnea in infants and children.

Other factors which can influence snoring are:

• Obesity
• Congestion of the throat due to reflux of stomach acid (heartburn)

If your child has loud snoring, you are advised to consult your physician, who may then refer your child to a Sleep Disorders Centre for a thorough evaluation.

Effective treatment is available for almost all patients. The treatment of snoring is divided into medical and surgical options. The choice of therapy will depend on the underlying cause and the extent of the problem.

A staged approach is often used, which involves medical therapy first, followed by consideration of surgery.

Medical

As nasal obstruction increases the frequency of snoring and sleep disordered breathing, your doctor may prescribe oral medications to help your child breathe through his nose during sleep.

For those diagnosed with sleep apnea, Nasal CPAP (Continuous Positive Airway Pressure) is used to supply pressurised air into the upper airway via a nasal mask. This keeps the upper airway open.

Surgical

Surgical procedures for the treatment of snoring may include surgery of the nose, palate, jaw, tongue and/or neck, depending on the location of the tissues contributing to the snoring.

Certain nasal conditions such as deviated nasal septum and very large tonsils may require assessment by the Ear, Nose & Throat (ENT) surgeon.

Some patients may have extra tissue in the throat, which when removed may help to alleviate snoring. This surgical procedure is called uvulopalatopharyngoplasty (UPPP). Excess tissues may also be removed using laser surgery. Another procedure, somnoplasty or radiofrequency thermal ablation of the soft palate, stiffens and shrinks the tissues of the soft palate, and is also used to treat snoring.

Ref: T12