Snoring In Children Research Articles

Effectiveness of Low-Temperature Plasma Adenoidectomy Combined with Bilateral Tonsillectomy in the Treatment of Snoring in Children and Its Effect on Sleep Quality

Objective: To evaluate the therapeutic effect of low-temperature plasma adenoidectomy (abbreviation: adenoid low-temperature plasma excision) coupled with tonsillectomy (bilateral) on snoring in children. Methods: Seventy-six cases of snoring children treated in the hospital between November 2020 and November 2023 were selected. 38 cases of children in Group A agreed to surgery and were admitted to the hospital for surgical treatment and were treated with adenoid cryo-plasma excision combined with tonsillectomy (bilaterally), and 38 cases of children in Group B did not agree to outpatient conservative treatment for surgery, and the results of the treatment were compared. Results: Before treatment, there was no difference between the ventilation function indexes, sleep quality scores, and quality of life scores of the two groups compared with each other (P > 0.05). After treatment, the ventilation function indexes of Group A were better than Group B, and the sleep quality score and quality of life score were higher than that of Group B. The total effective rate of Group A was higher than that of Group B (P < 0.05). Conclusion: Adenoid cryo-plasma excision combined with tonsillectomy (bilateral) can improve the quality of life, ventilation function, and sleep quality of children with snoring, and can enhance the efficacy.

A comparison of caregiver-reported snoring and objective snoring in children from urban neighborhoods

ObjectiveSleep Disordered Breathing (SDB) is both prevalent and under-recognized in pediatric minority populations. Recognition of SDB is often triggered by symptoms of caregiver-reported snoring. However, the validity and utility of caregiver reports likely vary across populations. Our objective is to assess the association between caregiver-reported snoring and objectively recorded snoring in a low-income urban community and explore factors associated with agreement between objective and subjective snoring. Methods169 6 to 12 year old participants underwent at-home sleep studies with a WatchPAT device as part of the Environmental Assessment of Sleep in Youth (EASY) cohort study. Differences in subjective snoring, objective snoring, and concordance between subjective and objective snoring based on socioeconomic and clinical characteristics were assessed. ResultsThe sample had a high proportion of non-white (78.9 %) and low income (39.6 %) children. Caregivers reported snoring for 20.7 % of the children and snoring was measured objectively for 21.9 %. Of those with objective snoring, only 29.7 % were identified as snorers by caregiver report (sensitivity: 0.30; specificity: 0.82). Primary Spanish language and co-sleeping were associated with increased caregiver reported snoring, and allergy was associated with increased objective snoring. Older child age and normal range BMI percentile were associated with higher concordance between caregiver and objective snoring. ConclusionsAmong a community-based, predominantly minority sample, caregiver-reported snoring resulted in under-estimation of prevalence of objectively assessed snoring. Reliance on caregiver report may poorly identify children with snoring or SDB in clinical practice.

Study on early intervention strategies of children's snoring: a meta-analysis based on network.

Study on early intervention strategies of children's snoring: a meta-analysis based on network.

Analysis of the Clinical Course of Children With Initial Negative Polysomnography.

To determine the clinical course of children with initial negative polysomnography (PSG) tests. A retrospective chart review was performed on pediatric patients seen by an otolaryngologist who underwent a PSG between October 2012 and March 2019 for obstructive sleep apnea at a single, academic, tertiary-care center. Data including demographics, follow-up PSG tests, and surgeries were collected. A total of 2018 pediatric patients underwent PSG during the timeframe. About 535/2018 (26.5%) patients were negative for obstructive sleep apnea by PSG and had no prior adenotonsillectomy. About 408/535 (76.3%) did not obtain follow-up testing or surgeries; 69/535 (12.9%) underwent subsequent adenotonsillectomy for worsening symptoms without repeat PSG; and 58/535 (10.8%) obtained 1 or multiple follow-up PSG tests. Of the 58 who obtained repeat PSG, 25 (43.1%) were subsequently positive, with 17 of those 25 (29.3% of 58) undergoing adenotonsillectomy. Taken together, 94/535 (17.6%) of patients with initial negative PSG had worsening sleep disordered breathing. A significant minority of children who initially tested negative for pediatric obstructive sleep apnea met criteria for diagnosis on follow up PSG. Additionally, other children with initial negative PSG underwent adenotonsillectomy for worsening symptoms in lieu of repeat testing. Patients should be educated that snoring in children could persist or worsen over time, even in the setting of a initial negative PSG.

A Study on the Progress of Acupuncture in the Treatment of Snoring in Children

A Study on the Progress of Acupuncture in the Treatment of Snoring in Children

Domestic Environmental Factors Associated with Pediatric Snoring: A Scoping Review Protocol

Since one-third of children who snore consistently may have OSAS, understanding the causes is vital. Preventing snoring requires addressing obesity, allergies, and anatomical anomalies. Indoor allergens and enlarged tonsils and adenoids may also cause youngsters to snore. The review aims to identify and categorize key concepts, types of evidence, and research gaps in this area. The scoping review will follow the methodology and stages outlined by the Joana Briggs Institute ((JBI). The final output will follow the PRISMA-Protocols (PRISMA-P) 2015 checklist. This review serves as a necessary step before conducting a systematic review and clinical studies. Childhood snoring is a common problem that can have adverse effects on a child’s health and well-being. It is importing ant for parents to understand the hazards of snoring and seek support if they suspect their child may have a sleep disorder. Treatment options vary depending on the cause and severity of snoring, and may include lifestyle changes, medication, or surgery. More research is need to better understand the relationship between environmental factors and snoring children, including the impact of pollutant such as NO2 and passive smoking. Early detection and treatment of snoring in children is crucial, as if can have long-term effects on their health and well-being. The conclusion is that knowledge empowers parents to take the necessary steps to ensure the well-being and healthy sleep of their children.

Reliability of parental reporting of child snoring in children referred for obstructive sleep apnea.

Despite the high number of studies based on subjective reports of snoring, self-reported snoring has hardly been validated at all. As there is no "gold-standard" for objective snoring measurements, studies must evaluate whether the presence of snoring based on parental judgement is linked to objective measurements of nasal and/or pharyngeal obstruction in children referred for obstructive sleep apnea. A total of 146 children (median age 11 years) underwent polysomnography (with snoring recording using nasal cannula signal), acoustic rhinometry and pharyngometry, while their parents filled out the Spruyt-Gozal questionnaire assessing both frequency and loudness of subjective snoring. Three categories were further differentiated (null, low and high) for both frequency and loudness. The apnea-hypopnea index was significantly different in the three groups for both frequency (p=0.04) and loudness (p=0.01) of subjective snoring. Children in the low or high groups (frequency or loudness), compared with those in the null group, experienced a decline in both pharyngeal (sitting and supine positions) and nasopharyngeal (supine position) volumes (frequency, pharynx sitting: p=0.03; supine: 0.005 and nasopharynx: p=0.002; loudness, p=0.03; p=0.007 and p=0.03; three group comparisons). Objective snoring frequency during the night obtained with cannula was weakly related to loudness of subjective snoring but not to subjective snoring frequency during the week, and was biased by nasal obstruction. In conclusion, our study showed that parental assessment of snoring is related to a reduction in both pharyngeal and nasopharyngeal volumes in snorers, arguing for the adequacy of their evaluation of both snoring frequency and loudness.

Relationship Between Adenotonsillar Size and Snoring Sound: Acoustic Analysis

Background and Objectives The most common cause of snoring in children is enlarged tonsils and adenoids. However, there is insufficient evidence to determine whether the subjective measurement of tonsil hypertrophy, the most common prevailing method, reflects the actual tonsil size and volume. Therefore, we tried to determine whether the subjective grading of tonsil size and actual tonsil volume is related, and whether tonsil volume, weight, and adenoid index are correlated with the acoustic analysis of snoring.Subjects and Method The study was conducted on 21 children between the ages of 4 and 15 who came for tonsillectomy and adenoidectomy due to snoring symptoms. The degree of adenotonsillar hypertrophy was measured using the Brodsky grading scale and adenoid index. After tonsillectomy, the volume and weight of resected tonsil were measured. For acoustic analysis, the Praat software was used to determine formant frequency and sound intensity. A linear regression model and a dummy variable were used to determine the correlation between the quantitative values of tonsil, adenoid and the result of acoustic analysis.Results The Brodsky tonsil grade tended to match the actual tonsil volume, but it was not statistically significant (<i>p</i>=0.073). There was no correlation between snoring intensity and actual tonsil volume, weight, and adenoid index. Formant frequency 1 and 2 were statistically negatively correlated with the actual tonsil volume (<i>p</i>=0.011, 0.002).Conclusion The study confirmed that the acoustic analysis of pediatric snoring could be a screening test to predict tonsil volume and changes in the vocal tract due to tonsil hypertrophy.

A Survey Study on Sleep Breathing in Individuals with Malocclusion Characterized by Maxillary Transversal Deficiency and Snoring Problem

Aim: The aim of this survey study is to evaluate the awareness of parents on sleep disorders and their side effects, and to measure their level of awareness to those respiratory problems can lead to dental and jaw disorders. 
 Materials and Methods: A survey was applied to the parents of 30 children whose average age was 11.86, who had snoring, mouth breathing, and narrow maxilla, who applied to the Department of Orthodontics, Faculty of Dentistry, Ankara University. While the first six questions of the questionnaire are about general information, the next 37 questions are about the smoking status of the parents, the child's snoring characteristics, and apnea, day and night complaints that are typically seen in children with Obstructive Sleep Apnea Syndrome. 
 Result: In our survey study, it was determined that the awareness of people that snoring in children can be a symptom of a disease is weak. 40% of parents do not have information on this issue. In addition to that, parents do not think that snoring seen in children while sleeping at night may influence school success. 
 Conclusion: In our study, it was found that the level of awareness of parents about the effects of breathing problems during sleep on jaw development was also low. Because of that, orthodontists and physicians interested in sleep should inform the society more about this issue.

Efficacy and safety of fluticasone propionate nasal spray in treatment ofadenoidal hypertrophic snoring in children

This study investigatedthe efficacy and safety offluticasone propionate nasal spray in treatment of adenoidal hypertrophic snoring in children.Fifty-six children with adenoidal hypertrophic snoring were enrolled. According to adenoidal-nasopharyngeal ratio (ANR) in lateral nasal X-ray examination,the children were assigned in moderategroup (23 cases) and severegroup (33 cases).The fluticasone propionate nasal spray was used for all patientsfor 4 weeks.In 56 patients, after treatment, compared with before treatment, the snoring, sleep apneaand nasal obstruction scores in moderategroupand the nasal obstruction score in severegroupwere significantly decreased,respectively (P < 0.05).The decreases of snoring, sleep apnea, mouth breathing and nasal obstruction scores after treatment in moderate group were significantly higher than those in severe group, respectively (P <0.001).After treatment, in 18 patients with ateral nasal X-ray examination,the adenoid size was obviously reduced, and the nasopharynx airway was obviously enlarged. The meanANRdropped from 0.76±0.10 to 0.72±0.09(P <0.001).Duringtreatment, only 2 of 56 patients were reported with intranasal dryness and occasional epistaxis, which were self-healed without treatment.Fluticasone propionate nasal spray is effective and safe for treatment of children’s snoring caused by adenoidal hypertrophy.

Chinese guideline for the diagnosis and treatment of childhood obstructive sleep apnea (2020).

Chinese guideline for the diagnosis and treatment of childhood obstructive sleep apnea (2020).

Prevalence and evolution of snoring and the associated factors in two-year-old children

ObjectivesTo evaluate the prevalence and persistence of snoring during the first two years of life in two Finnish birth cohorts and to assess the associated factors. Study designThe study population comprised 947 children from the CHILD-SLEEP (CS) and 1393 children from the FinnBrain (FB) birth cohorts. Questionnaires were provided to both parents when the child was 24 months of age. The questionnaire consisted of parts concerning the child's sleep and environmental factors. ResultsThe combined prevalence of habitual snoring in the two birth cohorts at the age of 24 months was 2.3% (95% CI 1.5–3.1), which is markedly lower than reported previously.Children suffering from recurrent infections (CS odds ratio (OR) 3.9, 95% CI 1.2–12.5) or asthma (FB OR 4.3, 1.4–13.5) snored habitually more often. Both the mother's (CS OR 3.2, 1.2–9.0) and father's (CS OR 3.4, 1.4–8.0) snoring every night added to the risk of the child snoring. In the multivariate models, parental snoring (CS adjusted odds ratio (ORa) 2.8, 1.1–6.8), the mother's lower level of education (CS ORa 2.9, 1.2–7.5, FB ORa 2.1, 1.0–4.5), and the mother's lower monthly income (FB ORa 2.9, 1.3–6.3) associated with the child's habitual snoring. ConclusionsThe prevalence of habitual snoring in two Finnish birth cohorts is lower than reported previously. The independent risk factors for habitual snoring at the age of two years were the parents' snoring and the mother's low income and low education.

Journal Digest: Amygdala and ‘Broken Heart’ Syndrome; Digital Intervention and Paranoia Symptoms; Snoring in Children and Brain Development; Impaired Self-Control and Binge Eating Behavior; HS Football and Midlife Mental Health Problems

Journal Digest: Amygdala and ‘Broken Heart’ Syndrome; Digital Intervention and Paranoia Symptoms; Snoring in Children and Brain Development; Impaired Self-Control and Binge Eating Behavior; HS Football and Midlife Mental Health Problems

Association Between Habitual Snoring and Cognitive Performance Among a Large Sample of Preadolescent Children

Previous studies have identified an association between habitual snoring and lower cognitive performance in children. However, whether and to what extent this association is confounded by pertinent demographic, anthropometric, and socioeconomic characteristics is unknown. To assess the extent to which potential confounding factors modify the association between parent-reported habitual snoring and cognitive outcomes among a large and diverse sample of typically developing preadolescent children. This cross-sectional analysis used a baseline data set (version 2.0.1) from children enrolled in the ongoing Adolescent Brain Cognitive Development study between September 1, 2016, and October 15, 2018. Children aged 9 to 10 years without serious psychiatric or neurological comorbidities were recruited at 21 research sites in the US. Study recruitment was designed to approximate the racial and socioeconomic diversity of the US population. Data were analyzed from February 1 to March 31, 2020. Parent-reported habitual snoring in children that occurs 3 or more nights per week. Associations between habitual snoring and cognitive performance were assessed using the Sleep Disturbance Scale for Children and the National Institutes of Health Toolbox Cognition Battery, which includes 7 domain-specific and 3 composite (total cognitive function, fluid cognition, and crystallized cognition) standard scores that are uncorrected for covariates. Cognitive performance was examined before and after adjustment for covariates, which included age, sex, body mass index percentile, annual household income before taxes, and highest educational level of caregiver. The extent of confounding was assessed by the effect size, represented by Cohen d, before and after inclusion of covariates using linear mixed-effects models. A total of 11 873 children aged 9 to 10 years (6187 boys [52.1%]; 6174 White [52.0%]) with available data were included in the study. Of those, habitual snoring (≥3 nights per week) was reported in 810 children (6.8%), and nonhabitual snoring (1-2 nights per week) was reported in 4058 children (34.2%). In the unadjusted models, the total cognitive function composite score among children who habitually snored was significantly lower compared with children who never snored (Cohen d, 0.35; 95% CI, 0.28-0.42). Differences were also identified in the crystallized cognition (Cohen d, 0.34; 95% CI, 0.26-0.41) and fluid cognition (Cohen d, 0.28; 95% CI, 0.21-0.35) composite scores. The association between habitual snoring and cognitive performance was substantially attenuated after adjustment for covariates (Cohen d, 0.16 [95% CI, 0.09 to 0.24] for total cognitive function, 0.14 [95% CI, 0.07 to 0.21] for crystallized cognition, and 0.13 [95% CI, 0.06 to 0.21] for fluid cognition). Similar mitigation was also observed for all domain-specific scores. In this cross-sectional study, when adjusted for baseline demographic, anthropometric, and socioeconomic characteristics, the association between parent-reported habitual snoring and cognitive performance was substantially attenuated among children aged 9 to 10 years.

Cumulative Early-Life Traffic-Related Air Pollution Exposure and Sleep Disturbance Consistent with Sleep Disordered Breathing among 12-Year-Old Children

Background/Aim: Exposure to traffic-related air pollution (TRAP) may be linked to sleep disordered breathing. The aim of this study was to assess whether cumulative early-life exposure to TRAP is associated with loud snoring and frequent napping among 12-year-old children.Methods: We used data from the Cincinnati Childhood Allergy and Air Pollution Study, a prospective birth cohort study of children in the greater Cincinnati, Ohio metropolitan area. Annual average exposures to TRAP at residential addresses from birth to 12-years-old were estimated using a previously-validated land use regression model of elemental carbon attributable to traffic. TRAP was dichotomized as high versus low at the 75th percentile (0.41 µg/m3) based on the distribution at age 12 years. Parental report of frequency of their child snoring loudly and napping was categorized as &lt;3 times per week versus ≥3 times per week. Using log-binomial regression, we estimated prevalence ratios (PR) of frequent loud snoring and napping among children with high versus low TRAP exposure. Models were adjusted for age, sex, race/ethnicity, annual household income, secondhand smoke expo-sure, and obesity status (95th body mass index percentile).Results: Among 313 children, the prevalence of frequent loud snoring was 10.0% and frequent napping was 12.0%. There was an over 2-fold higher prevalence of frequent snoring among children with high versus low TRAP exposure in the fully-adjusted model (PR:2.20, 95%Confidence Interval [CI]:1.10-4.40, p=0.025). There was over twice the prevalence of frequent napping among children with high versus low TRAP exposure in the unadjusted model (PR:2.48, 95%CI:1.38-4.46, p=0.002); however, this association was attenuated in the fully-adjusted model (PR:1.12, 95%CI:0.65-1.92, p=0.68).Conclusions: High levels of cumulative early-life TRAP exposure may contribute to symptoms consistent with sleep disordered breathing among children, which are both associated with a wide range of adverse human health effects including poor cardiometabolic health. More research is warranted.

Analysis of genetic and environmental risk factors in pediatric OSA

Objective:To investigate the genetic and family environmental risk factors of obstructive sleep apnea（OSA） in children with habitual snoring. Method:Children with habitual snoring who underwent overnight PSG were recruited. Subjects were divided into the snoring group and OSA group according to the criteria of the International Classification of Sleep Disorder（ICSD-3）. The demographic data, symptoms, signs and family environmental factors of the two groups were compared. Result:One hundred and fifty-five families were included（including children with habitual snoring and their parents）. Children were 3 to 13 years old, including 88 cases in the snoring group and 67 cases in the OSA group. Using binary logistic regression analysis, existence of apnea, higher BMI z score and mother's medical history of repeated tonsillitis and/or adenotonsillectomy in childhood were risk factors for OSA in children with habitual snoring, and the odds ratio（95%CI） was 4.081（1.835, 9.073）, 1.347（1.071, 1.694）, 3.897（1.400, 10.849） respectively. There were no significant differences in the distribution of environmental factors such as family residence, per capita household income, and parental smoking history. Conclusion:The risk factors of OSA in habitual snoring children are symptom of apnea, higher BMI z score and mother's medical history of repeated tonsillitis and/or adenotonsillectomy in childhood.

Le ronflement peut-il être un symptôme d’allergie ? Cas clinique et revue de la littérature

Snoring in children may be due to several causes that may succeed one another throughout the first ten years of life. Allergic rhinitis should be considered where there is nasal obstruction with congestion of the inferior turbinates. This diagnosis may be confirmed by prick-tests. Treatment consists of nasal corticosteroids and oral antihistamine. Where possible, oral desensitisation should be proposed if snoring persists or if the rhinitis is associated with asthma.

0929 Caregiver-Reported Versus Clinician-Documented Child Sleep Problems and Sleep-Related Health Behaviors in Primary Care

Abstract Introduction Sleep problems are highly prevalent in early childhood but often under-identified in pediatric primary care. This study identified the prevalence of caregiver-reported versus primary care provider (PCP)-documented sleep problems and sleep-related health behaviors in young children presenting to well child visits (WCVs). Methods Caregivers (85.4% mothers) of 198 young children (2-5 years, M = 3.3, 53.7% female, 62.9% Black) presenting to urban (74.1%) and suburban (25.9%) primary care sites for well child visits (WCVs) completed research surveys on child behavioral sleep problems, snoring, and sleep-related health behaviors (e.g., caffeine consumption) on the day of their child’s WCV. Electronic medical record review was used to identify the rate of PCP-documented sleep problems and related recommendations in the WCV progress note. Results Fifteen percent of caregivers reported a child sleep problem according to questionnaire data, which did not significantly differ from the 12.0% of children with a PCP-documented sleep problem in the WCV progress note (p = .31). However, significantly more caregivers (28.3%) reported bedtime difficulties (resistance; tantrums) on questionnaires (p &amp;lt;.001), which were not captured in the 12.0% of WCVs noting sleep problems. A total of 8% of WCVs included child sleep recommendations. Child snoring was reported by 17.0% of caregivers, but was less frequently documented in WCVs (4.5%, p &amp;lt;.001). Although many caregivers reported poor child sleep-related health behaviors, including daily child caffeine consumption (21.1%) and bedroom electronics (62.9%), significantly fewer PCPs documented these issues (caffeine: 2.0%; electronics: 6.6%) or related recommendations (decrease caffeine: 1.0%; eliminate electronics: 3.5%) in the progress note (all p-values &amp;lt;.001). Conclusion Although caregiver-endorsed child sleep problems on surveys did not differ from PCP-documented concerns, there are gaps in documenting other problematic sleep-related health behaviors, such as caffeine consumption and electronics use. More resources to address sleep-related health behaviors, as well as sleep problems, in pediatric primary care are needed. Support Sleep Research Society Foundation and K23HD094905 (AAW)

Research Progress of Traditional Chinese Medicine and Western Medicine on Snoring in Children

Research Progress of Traditional Chinese Medicine and Western Medicine on Snoring in Children

Approach to the snoring child.

Sleep is an important component in a child's growth and development. Snoring is common in children and often perceived as benign, but habitual snoring may be an indication of obstructive sleep apnoea (OSA). OSA can have health, developmental and cognitive consequences. The three common risk factors for paediatric OSA are tonsillar and/or adenoidal hypertrophy, obesity and allergic rhinitis. Primary care providers are well-placed to identify children at risk by screening for habitual snoring and associated OSA risk factors during routine consultations. Physician awareness of OSA symptoms/signs facilitates diagnosis, management and referral decisions. A trial of medical treatment may be considered for habitual snoring with mild symptoms/signs before referral. Overnight polysomnography is the gold standard investigation utilised by paediatric sleep specialists to diagnose OSA. Adenotonsillectomy is the first-line management for OSA with adenotonsillar hypertrophy, but residual/recurrent OSA may occur, so follow-up by primary care providers is important after surgery.