Snoring in the Obese Child

Is overweight or obesity causing sleep apnea in your child?

Of the very long list of health problems that childhood obesity can create, another health problem is the development of ear, nose and throat problems . . . including the development of sleep apnea.

Does your child snore? Does your child show other signs of disturbed sleep: long pauses in breathing, a lot of tossing and turning in bed, chronic mouth breathing during sleep, night sweats (owing to increased effort to breathe)? All these, but especially the snoring, are possible signs of sleep apnea.

Obstructive sleep apnea (OSA), is a common condition associated with snoring where the upper airway (breathing tube) closes intermittently at night leading to sleep disruption. The traditional image of the child with sleep apnea used to be a skinny, hyperactive child with large tonsils, usually between the ages 3-8. This child would snore and gasp at night. Removal of the tonsils and adenoids (adenotonsillectomy) would result in resolution of the snoring and sleep disruption, as well as the daytime behavioral issues—in short, a cure.

Things are very different these days. While the classic picture of the child with OSA still exists, with the obesity epidemic, the evaluation and management of children with snoring has become more complex.

Why does it matter if a child is obese AND snoring?

• Because the risk of obstructive sleep apnea is much higher. One third of obese children will suffer from OSA, compared with 2-4% of non-obese children. Fifty percent of obese snoring children will have OSA because (a) the upper airway is smaller and thus easier to collapse, and (b) research has shown that fat in the belly is more likely to be associated with OSA by pushing up on the lungs and making them smaller.

• Because OSA in obese children usually looks more like adult OSA in that it is associated with daytime sleepiness and depression.

• Because OSA pushes obese children towards obesity related medical conditions such as hypertension, cholesterol problems, and pre-diabetes.

• Because the sleep apnea is more severe.  Drops in oxygen levels are more common and more severe in children with obesity.

• Because OSA is more difficult to treat.  Surgery is more likely to have complications in obese children, and removal of the tonsils and adenoids is still helpful, but significantly less likely to result in a cure.  Obese children frequently gain more weight after surgery and have a higher rate of recurrence of sleep apnea.

The most common treatment for OSA consists of continuous positive airway pressure (CPAP) applied via a mask during the night to keep the airway open.  Needless to say, for most children, it takes a whole lot of getting used to, and for many parents, it’s hard for them to see their child having to do so.

It is vitally important for parents of obese children to watch for warning signs and symptoms of sleep apnea.  If any are present, make an appointment with your child’s pediatrician. If it’s just snoring and not a health complication, check the Snore Pillows review. It might be all that you need. Take note however, that such products will not help with apnea or anything serious like that.

It is also vitally important that you do something about your child’s weight!