Sleep problems in children – snoring, sleep apnea and other causes
Many children sleep poorly at times, and most often it is temporary. When a child snores loudly, wakes up many times or seems tired and unmotivated during the day, there may be a reason behind it that can be investigated and treated. At Charlottenlund Private Hospital, we investigate children who sleep restlessly and find out what is disturbing their sleep.
Sleep problems in children include restless sleep, frequent awakenings, snoring or pauses in breathing during sleep. In children, these problems are often caused by physical conditions affecting the upper airways — typically enlarged tonsils or adenoids — but ear pain, constipation and reflux can also disturb sleep. Only a small proportion of children who snore have actual sleep apnoea, but it is important to investigate this possibility because poor sleep over time can affect a child's well-being, mood and concentration.
What Are the Symptoms of Sleep Problems in Children?
Sleep problems in children can cause symptoms both at night and during the day.
At night, a child may snore, breathe through their mouth, sleep restlessly, sweat, wake frequently or experience pauses in breathing.
Some children under the age of two wake up after just 30–40 minutes of sleep and struggle to settle down again.
During the day, poor sleep may cause tiredness, but children just as often experience restlessness, irritability, mood swings and difficulty concentrating, which can be mistaken for other conditions.
Prolonged periods of disrupted sleep should therefore be taken seriously.
What Is Sleep Apnoea in Children?
Sleep apnoea in children (obstructive sleep apnoea, OSA) is a condition involving repeated pauses in breathing during sleep because the upper airways partially or completely collapse.
The child typically snores loudly, experiences laboured breathing and has brief pauses in breathing followed by gasping or waking up.
In children, the most common cause is enlarged tonsils and adenoids, and the condition occurs most frequently between the ages of two and six.
Snoring alone is not the same as sleep apnoea. However, according to Ugeskrift for Læger (Danish Medical Journal), medical history alone is often insufficient to determine whether a child who snores has sleep apnoea.
Children with pronounced snoring or pauses in breathing during sleep should therefore be examined.
Why Do Children Snore?
Snoring occurs when airflow through the nose and throat becomes restricted during sleep, causing soft tissues to vibrate.
In children, this is most commonly caused by enlarged tonsils or adenoids that obstruct the airway. However, a blocked nose or persistent nasal congestion due to colds or allergies can also cause snoring.
Occasional snoring during a cold is harmless.
However, if a child snores almost every night, breathes through their mouth during the day or experiences pauses in breathing during sleep, they should be examined by an ear, nose and throat (ENT) specialist.
What Causes Sleep Problems in Children?
Sleep problems in children often have a physical cause affecting the upper airways, although this is not always the case.
The most common causes include:
- Enlarged tonsils and adenoids. Enlarged lymphatic tissue in the throat and nasopharynx can, according to the national clinical guideline on tonsil removal, obstruct the airway and cause snoring, mouth breathing and sleep apnoea. Adenoids can also block the passage between the nasopharynx and the middle ear, causing fluid to accumulate in the middle ear and leading to recurring ear problems. Read more about adenoid removal and tonsil reduction.
- Ear problems. Fluid in the middle ear or middle ear infections can cause pressure and pain, which typically worsen when the child lies down and may lead to frequent awakenings. In cases of persistent fluid accumulation, ear tubes (grommets) may provide relief.
- Gastrointestinal conditions. Reflux or constipation can cause discomfort that disrupts sleep, particularly when the child is lying down.
- Sleep habits and other factors. Irregular bedtimes, screen time before bed or tension in the body and neck can also affect sleep.
When the cause cannot immediately be identified in the ears, nose or throat, we carry out a comprehensive assessment to determine what may be disturbing the child's sleep.
How Is a Child With Sleep Problems Examined?
The examination begins with a discussion about the child's sleep, breathing and daily routine.
The specialist then examines the ears, nose and throat to assess whether there is fluid in the middle ear, enlarged tonsils or enlarged adenoids.
Many sleep problems in children can be identified through this clinical examination.
The specialist's overall assessment always determines which examinations are necessary for each individual child.
How Are Sleep Problems in Children Treated?
Treatment depends on the underlying cause and is tailored individually.
If the problems are caused by enlarged tonsils or adenoids, surgery to remove or reduce the tissue can often lead to a noticeable improvement in both sleep and breathing.
If persistent fluid is present in the middle ear, ear tubes may provide relief.
If poor sleep is caused by reflux, constipation or unsuitable sleep habits, treatment focuses on addressing these issues.
For pain, over-the-counter painkillers may provide short-term relief, but their effects rarely last throughout the night, and they do not address the underlying cause.
The doctor will always assess which treatment is most appropriate.
When Should You Seek Medical Advice About Your Child's Sleep?
It is advisable to seek medical advice if your child snores almost every night, experiences pauses in breathing during sleep, breathes through their mouth during the day or appears to be affected by poor sleep in everyday life.
The same applies if your child experiences recurring ear problems, reduced hearing or frequent awakenings due to pain.
A medical examination can help determine whether there is an underlying cause that can be treated.
Sleep Problems in Children at Charlottenlund Privathospital
At Charlottenlund Privathospital, children with sleep problems are examined by ear, nose and throat (ENT) specialists and, where necessary, can receive a multidisciplinary assessment involving paediatric specialists.
We have specially trained anaesthesia and recovery staff experienced in administering anaesthesia to young children, and we provide anaesthesia for children as young as six months old.
Examinations and treatment are provided on an outpatient basis and are tailored to each individual child.
If the underlying cause lies outside the ears, nose and throat, we provide guidance on the appropriate next steps based on a comprehensive assessment.
You can find an overview of all departments on our departments page.
Sources:
- Ugeskrift for Læger (Danish Medical Journal): Sleep-Related Breathing Disorders – covering snoring, sleep apnoea and adenotonsillar hypertrophy in children.
- National Clinical Guideline on Tonsil Removal (tonsillectomy).
Frequently Asked Questions
What is sleep apnea in children?
Sleep apnea in children (obstructive sleep apnea) is repeated pauses in breathing during sleep, most often caused by enlarged tonsils or tonsil polyps. The child typically snores loudly and has labored breathing.
What are the symptoms of sleep apnea in children?
Loud snoring, pauses in breathing followed by gasps, mouth breathing, restless sleep, sweating, and daytime fatigue or restlessness. Symptoms are most often seen between the ages of 2-6.
Can a baby have sleep apnea?
Yes, sleep apnea can be seen in infants. In the youngest children, it is more often due to anatomical conditions, while enlarged tonsils and pediatric polyps are the most common cause in older children.
When should snoring in children be investigated?
Occasional snoring when you have a cold is not dangerous. If a child snores almost every night, pauses in breathing, or breathes through their mouth during the day, they should be examined.
What do large tonsils, drooling, and snoring in children mean?
This is a typical picture of enlarged tonsils and/or childhood polyps blocking the airway. It should be examined by an ear, nose and throat doctor, as it can affect sleep and breathing.
Why do children wake up often at night?
Frequent awakenings can be caused by ear pain, fluid in the middle ear, snoring or sleep apnea, reflux, or constipation. An examination can clarify the cause.
What could be the reason when a 2-year-old child sleeps poorly?
In young children, restless sleep can be caused by ear problems, enlarged polyps or stomach symptoms. If the child wakes up frequently after a short period of sleep, an assessment can clarify whether there is a cause that can be treated.
Can enlarged polyps affect schoolchildren's sleep and concentration?
Yes. Poor sleep due to blocked airways can cause fatigue, restlessness and difficulty concentrating during the day, even in school-age children.
Do sleep problems in children go away on their own?
Some do, especially if they are caused by a passing cold. If they are caused by enlarged tonsils or polyps, they rarely go away without treatment, but can often be remedied.
Does a child need a referral?
It is not a requirement to have a referral to book an appointment. For health insurance, the conditions should be checked, as some companies require a referral as a condition of coverage.
Book an appointment:
If you would like to book an appointment, you are very welcome to contact us.
Our secretaries are ready to help you find a time for an initial interview that suits you.
You can book an appointment online or contact us by phone at 44981921.