For a 6 year old who snores, is tonsils usually the cause, or are there other contributing factors? (photo)

Doctor's Answers (1)

Thank you for your enquiry. Snoring is one of the most common symptoms seen in my clinical practice. Although many may brush off snoring as just a social nuisance, it is important to be aware that snoring is often a sign of a potentially harmful condition known as obstructive sleep apnoea (OSA). OSA refers to a condition in which one chokes or momentarily "stops breathing" repetitively during sleep due to repeated episodes of upper airway collapse. Common causes of snoring, especially in children, include:

1. Nasal blockage or congestion - This may be due to nasal allergies, sinus infections or enlarged adenoids or a severely deviated nasal septum (bent septum in the nose)

2. Large tonsils - Tonsils are two ovoid-like lump of tissues at the back of your throat (you have a right and left tonsils). Based on the picture that you provided, your child's tonsils are large and likely one of the major cause of snoring. Although they are part of your immune system, they play a very small role. Larger immune organs such as your liver, spleen, lymphatic system and bone marrow play a far greater role. Numerous studies have shown that removal of the tonsils (if problematic e.g. in patients with snoring or sleep apnoea or in patients with recurrent tonsil infections), do not have a significant effect on the immune system. 

3. Obesity

4. Small/receding chin 

5. Bulky base of tongue or large lingual tonsils 

Apart from snoring, other common symptoms of OSA in a child include:

1. Increased daytime sleepiness

2. Inability to concentrate during school

3. Behavioural problems (e.g symptoms of Attention-Deficit Hyperactivity Disorder)

4. Frequent urination at night/bed-wetting

Untreated OSA in children can potentially lead to poor performance in school as well as behavioural or growth disturbances. I would suggest an assessment by an ENT Specialist if your child demonstrates some of the symptoms listed above. 

Hope this helps and all the best!

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