Question: My six-year-old daughter generally sleeps well. She has a regular bedtime (8PM to 7AM) and has lots of energy during the day. However, she goes through periods in which she snores and seems to have broken breathing or holds her breath for a few seconds while she sleeps. She also regularly grinds her teeth. Even when she is not having these problems, she breathes heavily.
When she was four-years-old I took her to an ear, nose, and throat doctor who told me she had large adenoids but that they would stop growing and begin to disappear when she was around six or seven-years-old and did not recommend surgery. She suggested this could be the cause of her breathing problems at night.Although these sleep problems don’t seem to be making her tired during the day, we want to make sure she is healthy. What should we do?

Answer: Thanks for writing in. Large adenoids or tonsils do indeed often contribute to sleep apnea in children, by making the airway smaller and easier to suck closed.While she could soon grow out of it, as your doctor suggested, sleep apnea can also have developmental consequences in children because of the way it disrupts sleep. Typically, ending a period of halted breathing during sleep requires the sleeper to have a micro-awakening. Compounded over the night, this can fragment the sleep period pretty heavily, including non-REM slow wave sleep, when much of our growth hormones are released. It does typically result in daytime sleepiness though, which you suggest she is not experiencing. It still might be a good idea to consult a sleep disorder specialist and maybe even get her AHI (apnea/hypopnea index) measured to gauge the severity of her breathing issue.The teeth grinding during the night is a sleep disorder known as bruxism, and the sleep doctor should be able to give you some advice on that as well. I think apneas can be a trigger for it. But if it’s bad, the teeth should be protected, and your dentist might also be able to help with that by means of a mouth guard.

Thanks for your question and good luck,
Kevin