Practice 10-Minute Consultation

A snoring child

BMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j2124 (Published 18 May 2017) Cite this as: BMJ 2017;357:j2124
  1. Jared Gursanscky, paediatric trainee1,
  2. Marnee Boston, general practitioner2,
  3. Tawakir Kamani, consultant otolaryngologist3
  1. 1Royal Children’s Hospital, Melbourne, Victoria, Australia
  2. 2Airlie Women’s Clinic, Melbourne, Victoria, Australia
  3. 3Nottingham University Hospitals, Nottingham, UK
  4. Correspondence to: J Gursanscky jgursanscky@gmail.com
  • Accepted 25 April 2017

What you need to know

  • Around one in 10 of children snore, but only 1%-4% of children have obstructive sleep apnoea

  • Refer children with a history of snoring and any additional features of obstructive sleep apnoea to an otolaryngologist

  • Treatment can include intranasal steroids, adenotonsillectomy, and weight loss if indicated

The parents of a 4 year old child complain that he is snoring loudly, is restless during sleep, and is irritable during the day.

Snoring occurs in 8%-15% of children, while obstructive sleep apnoea occurs in 1%-4%.1 2 The spectrum of sleep disordered breathing extends from normal breathing and uncomplicated snoring through to obstructive sleep apnoea, with increasing degrees of airway obstruction (fig 1). Parents are often concerned about snoring because of the disordered breathing and behaviour changes that sometimes accompany it, and the possibility of an underlying medical cause. This first consultation will help to discriminate obstructive sleep apnoea from uncomplicated snoring.

Fig 1 Spectrum of symptoms and signs seen in sleep disordered breathing

Snoring results from turbulent airflow and vibration of soft tissues. In children, the primary cause of airflow turbulence …

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