How common is it
Habitual snoring affects approximately 10 percent of children. Of those, a meaningful fraction has obstructive sleep apnea — a condition that pediatricians once attributed to "growing pains" and that we now know carries real cognitive and developmental cost.
What parents notice
- Loud, audible snoring most nights of the week
- Witnessed pauses in breathing or gasping during sleep
- Restless sleep with frequent position changes
- Mouth-breathing during sleep or even when awake
- Bed-wetting after age six, especially if it returned after a dry period
- Daytime fatigue, hyperactivity, or behavioral irritability
- Trouble concentrating at school; declining academic performance
- Persistent morning headaches
Common causes
- Enlarged tonsils and adenoids — the most common cause in children, peak years 3–7
- Allergic rhinitis — chronic nasal congestion contributes to mouth-breathing
- Obesity — increasingly seen in older children and adolescents
- Craniofacial features — narrow palate, small jaw, large tongue
- Neuromuscular conditions — less common but require specialized care
How we evaluate
Parent-only consultation
We start with the parents so the family can speak openly about behavior, school, and home dynamics.
Pediatric examination
Tonsil grading, nasal patency, palate shape, and growth-chart review.
Pediatric polysomnogram
An overnight in our dedicated pediatric sleep lab with a parent accompanying.
Multi-specialty review
Sleep medicine, ENT, and when relevant, dentistry and growth specialists review the case together.
Treatment
- Tonsillectomy and adenoidectomy — first-line for most cases with significant tonsillar hypertrophy. Resolves OSA in 70–90 percent of healthy-weight children.
- Allergic rhinitis management — when nasal congestion is the primary driver
- Weight management — when applicable, conducted with pediatric nutrition support
- Myofunctional therapy — tongue and palate exercises for residual mouth-breathing
- CPAP in selected cases — for severe OSA, complex anatomy, or post-surgical residual events
- Orthodontic referral — for narrow palate, palatal expansion can be transformative
Follow-up
We schedule a post-treatment polysomnogram three to six months after intervention to verify outcome. Annual review for at least two years; longer if growth or symptoms warrant.
A child who suddenly performs better at school three months after tonsillectomy is not a coincidence. It is the consequence of sleep that finally consolidates memory. — Dr. Han Jin-Kyu