How Snoring in Children May Stunt Their Growth

Sleep Apnea Disturbs Slow-Wave Sleep and Growth Hormone Release in Children

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A toddler boy sleeps on his back. Cornelia Schauermann/Cultura/Getty Images

Snoring may seem harmless – and even cute – in a child. Unfortunately, snoring can have serious consequences among the young. In fact, chronic snoring in children is never normal. The American Academy of Pediatrics recommends that all children be screened for snoring and those who chronically snore should have a sleep study or be evaluated by a sleep specialist. Importantly, snoring may actually affect your children’s behavior and growth.

How does snoring in children stunt their growth?

The Role of Sleep Apnea and Slow-Wave Sleep

Snoring may not occur in isolation. Instead, it may be associated with obstructive sleep apnea. In this condition, the upper airway partially or completely collapses during sleep. There are multiple causes in children: it may occur secondary to allergies, tonsil or adenoid enlargement, and obesity. For children, more than once collapse of the airway per hour (often reported in studies as the AHI) is considered to be abnormal. This apnea can lead to sleep fragmentation in which awakenings occur to restore normal breathing. This fragmentation may have other consequences.

In the first third of the night, slow-wave sleep predominates. During this state of sleep, growth hormone is released. When it becomes fragmented due to abnormal breathing, there can be disruption of growth hormone release in children.

The signal is weakened and, as a result, the child does not grow normally.

Your child has a growth potential – a predetermined height and weight – written into his or her genes, but it can only be realized in optimal conditions. If malnutrition occurs, the full potential cannot be reached. Similarly, sleep apnea may interfere with normal growth.

Optimal sleep quantity and quality may be necessary for normal development.

Treatment Improves Growth in Children with Sleep Apnea

Fortunately, treatment of sleep apnea can be highly effective in children and potentially prevent a lifelong need of CPAP therapy. Children may benefit from allergy treatment, orthodontic work such as rapid maxillary expansion, myofunctional therapy, and tonsillectomy. Changes can be made now that may have lifelong benefits.

When treated, many children with sleep apnea experience a growth rebound. For example, after a tonsillectomy a child may grow vigorously in the subsequent months. In a sense, they resume their prior growth pattern and sometimes have significant movement in their growth percentile that is tracked at routine doctor visits.

Sleep apnea runs in families, so if you or your close relatives have the condition, look for it among the family's children. If you are concerned about your child’s snoring, speak with you doctor about the need for further testing and treatment.

In so doing, you can give your child the best chance to reach their full potential.

Sources:

Agras, WS et al. "Risk factors for childhood overweight: a prospective study from birth to 9.5 years." J Pediatr. 2004;145(1):20-25.

Durmer, JS et al. "Pediatric Sleep Medicine." Continuum Neurol. 2007;13(3):158.

Marcus CL et al. “Diagnosis and Management of Childhood Obstructive Sleep Apnea Syndrome.” Pediatrics. Originally published online August 27, 2012; DOI: 10.1542/peds.2012-1671. Last accessed: April 25, 2015.

Taheri, S. "The link between short sleep duration and obesity: we should recommend more sleep to prevent obesity." Arch. Dis. Child. 2006;91;881-884.

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