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Snoring Toddler

Ask our expert about sleep apnea in toddlers

My toddler snores and often wakes up in the middle of the night. Is this a normal part of childhood?
What is obstructive sleep apnea?
How common is pediatric sleep apnea?
I’m not sure if my child has sleep apnea. How do I know?
I’ve heard that toddlers with sleep apnea should sleep on their side or stomach. Aren’t they supposed to sleep on their backs to prevent Sudden Infant Death Syndrome (SIDS)?
My child is used to sleeping on his back. How do I get him to sleep on his side?
Won’t my child grow out of it?
How is sleep apnea diagnosed? Will my child need to get his tonsils removed?

Q: My toddler snores and often wakes up in the middle of the night. Is this a normal part of childhood?

A: No. Toddlers between ages 1- and 5- years of age should be sleeping through the night. Their restless sleep may be a symptom of obstructive sleep apnea – a serious sleep disorder that can affect learning, behavior and growth if not treated. Talk to your pediatrician about their symptoms as soon as possible.

Q: What is obstructive sleep apnea?

A: Sleep apnea occurs when a person regularly stops breathing during sleep for 10 seconds or longer. It can be classified as mild, moderate or severe, based on the number of times in an hour that breathing stops (apnea) or is shallow.

Because of their enlarged tonsils and adenoids, located at the back of the throat, toddlers are susceptible to a specific type of sleep apnea called obstructive sleep apnea (OSA). With sleep apnea, the flow of air is blocked during sleep. Once the tonsils and adenoids are removed, the severity of sleep apnea often decreases and symptoms subside.

Q: How common is pediatric sleep apnea?

A: Pediatric obstructive sleep apnea affects 2 to 3 percent of children in the U.S. and is primarily caused by enlarged tonsils and adenoids. This condition peaks between the ages of two and five.

Q: I’m not sure if my child has sleep apnea. How do I know?

A: Some of the common signs to watch for in children ages one to five are: snoring, loud or noisy breathing, stuffy nose, breathing through the mouth during the day or night, and restlessness or behavioral problems such as hyperactivity. Other more serious symptoms include flipping around excessively in bed, gasping for air or sleepwalking.

At the first sign of these symptoms, call your pediatrician. Your child may need their tonsils and adenoids removed, a simple outpatient procedure that eliminates the most common cause for toddlers’ restless sleep.

Q: I’ve heard that toddlers with sleep apnea should sleep on their side or stomach. Aren’t they supposed to sleep on their backs to prevent Sudden Infant Death Syndrome (SIDS)?

A: You’re right. It is vital that infants sleep on their back during the first year of life to prevent SIDS—as recommended by the American Association of Pediatrics. But after children turn one, they are at decreased risk for SIDS and sleeping on their back may no longer be the best position. For example, a recent study of toddlers with sleep apnea showed that the more time they slept on their back, the greater the number of sleep disruptions they experienced.

Q: My child is used to sleeping on his back. How do I get him to sleep on his side?

A: Try turning your child on his side while he is sleeping. Another option is to place something behind him, such as a rolled-up towel, to keep him from rolling back. If you are concerned about your child’s breathing at night, remember to call the pediatrician in the morning. Changing their sleeping position is only a temporary fix for what could be a more serious problem.

Q: Won’t my child grow out of it?

A: Some children outgrow sleep apnea by age 10 or 11, but others may carry it into their teen or adult years. Remember, obstructive sleep apnea can cause learning, growth and behavioral problems if not properly treated. It can also cause children to resist sleeping alone or to sleep during the day instead of at night.

Q: How is sleep apnea diagnosed? Will my child need to get his tonsils removed?

A: By looking into your child’s throat, a pediatrician usually can tell whether or not the tonsils and adenoids are enlarged. Then they will either refer your child to an ear, nose and throat (ENT) physician who will remove the tonsils and adenoids, or have a sleep study done to learn more.

At Lehigh Valley Hospital, sleep studies are performed in a comfortable Sleep Disorder Center, where a parent or guardian can stay through the night in an adjacent room. Children usually arrive in their pajamas in the evening, and sleep technicians work one-on-one with them. Sensors are attached to the child and the sleep technician watches and listens through the night. Parents can stay at the bedside before their child dozes off and the next day meet with the sleep specialist to discuss the diagnosis and treatment options.

This page last updated 1/6/09 01:48 PM