Snoring is commonly known as snoring, the medical term for snoring, is a widespread sleep phenomenon, most people currently think it is commonplace and do not take it seriously, and others see snoring as a sign of a good night’s sleep. In fact, snoring is the enemy of health, because snoring makes sleep breathing repeatedly suspended, causing serious lack of oxygen to the brain and blood, forming hypoxemia, and causing a series of systemic pathologies. Snoring in children is a relatively common situation in our daily life, but there are most parents who think that snoring is a sign that their children are sleeping heavily and well, which is not true. The following knowledge about children’s snoring is introduced in the hope that it will be helpful to parents.
Snoring, also known as sleep apnea hypoventilation syndrome, is a series of pathophysiological changes caused by frequent partial or total upper airway obstruction during sleep, which disturbs normal ventilation and sleep structure. There are obstructive, central and mixed syndromes. Obstructive snoring in children is mainly common and is called obstructive sleep apnea hypoventilation syndrome (OSAHS) in children, which is a syndrome with clinical manifestations such as growth arrest, abnormal cardiopulmonary function, neurological damage and behavioral abnormalities due to partial or total upper airway obstruction, resulting in hypoxemia during sleep.
I. Clinical manifestations and diagnosis of snoring in children
Nocturnal manifestations: snoring, open-mouth breathing, labored breathing, trigeminal sign, rib edge outward, contradictory movement of chest and abdomen during inspiration, and even cyanosis of mouth and lips. In severe cases, snoring can be terminated with only high-pitched grunts and apnea can occur. Sleep disturbance, sleep panic, night sweating, abnormal sleeping position, inability to lie on the back, awakening, struggling or even sitting up, some children have bedwetting.
Daytime symptoms: morning awakening symptoms include open-mouth breathing, morning headache, dry mouth, disorientation, confusion and irritability, hyperactivity, and abnormal personality behavior; in school-age children, it is characterized by poor concentration in class, daydreaming, lethargy, poor academic performance, developmental delay, and susceptibility to upper respiratory infections.
Sleep apnea monitoring is the gold standard for diagnosis and can provide a full understanding of the nocturnal onset of the child. However, because of the conditions, most of them can be diagnosed by symptoms and signs.
Common causes and main pathogenesis of snoring in children
1. Tonsil and adenoid hypertrophy is the most common cause of snoring in children.
2. Obesity is an important pathogenic factor of snoring in children.
3.Craniofacial developmental abnormalities are the risk factors of snoring in children.
4.Other factors: such as rhinitis, allergic rhinitis, sinusitis, etc.
Due to the presence of the above factors, the narrowing of the upper airway, together with the posterior fall of the tongue root and the obvious reduction of pharyngeal dilator muscle tone during night sleep, makes the upper airway easy to close and OSA occurs.
Due to the anatomical narrowing of the upper airway and the dysregulation of respiratory regulation, the force that opens the upper airway is mainly the tone of the pharyngeal dilator muscles, including the chin-lingual, pharyngeal-palatal and lingual-palatal muscles. During sleep, especially in the rapid eye movement (REM) sleep period, the
Third, the main harm of children’s snoring
1. It leads to slow growth and development of children.
Snoring makes the child sleep poorly, which inevitably reduces the release of growth hormone and affects the bone development of the child.
2, leading to children’s intellectual development backward.
Snoring will make the child seriously lack of oxygen during sleep, which directly leads to the lack of oxygen supply to the brain of the child, and the longer period of lack of oxygen will affect the intellectual development of the child.
3. Snoring can affect the face of children.
The nasopharyngeal congestion, open mouth breathing, and abnormal bite of upper and lower teeth can lead to abnormal facial development and “adenoid face” over time.
4. Causes secretory otitis media.
If the hypertrophic adenoids block the pharyngeal tube of the lateral wall of the pharynx, it will cause secretory otitis media, resulting in tinnitus, ear congestion and hearing loss.
5. It is easy to cause upper respiratory tract infection repeatedly, which will increase the burden of heart and lungs and cause abnormal heart and lung function.
IV. Treatment of snoring in children
OSAHS is not only a respiratory disease, but a disease involving multiple organs, systems and disciplines. In order to prevent serious OSAHS complications and improve the quality of life of the children, early detection, early diagnosis and early treatment are needed.
The principles of treatment mainly target the etiology and address the obstruction of the airway.
For most children with simple adenoids and/or tonsillar hypertrophy, surgical removal of the tonsils and/or adenoids is the most effective treatment.
2.Continuous positive airway pressure (CPAP) ventilation.
3.Conservative treatment: including observation, postural treatment, weight loss for obese patients, oxygen, etc.
4.Medication: for allergic rhinitis, sinusitis or acute attack of tonsillitis and other disease treatment.
V. Preventive measures for children snoring
1. Pay attention to balanced nutrition to avoid obesity from overnutrition.
2.Ensure the regularity of children’s work and rest time, and reduce the strenuous activities at night.
3. Pay attention to strengthening resistance, reducing the occurrence of various acute and chronic respiratory diseases, and avoiding respiratory obstruction caused by inflammation.