Natural history of primary snoring in children

Snoring, noisy breathing in sleep and daytime behaviour in 2–4-month-old infants

“…There is no general agreement whether and to what extent infants with parental-reported primary snoring during sleep may progress to develop obstructive sleep apnoea. While some authors argued that parental concern about infant's breathing patterns during sleep was a poor predictor of polysomnographic abnormalities [31], others reported that snoring and/or noisy (heavy, audible, gurgling) breathing in infants was associated with con®rmed prolonged and repetitive obstructive sleep apnoeas [14,23]. The number and length of obstructive sleep apnoeas in snoring infants may be a less important adverse factor than the repetitive inspiratory increases in upper airway resistance, even if these are associated only with a partial airway collapse and do not lead to pronounced blood oxygen desaturation [13].…”

Neurobehavioral Implications of Habitual Snoring in Children

“…9 Daytime sleepiness, behavioral hyperactivity, learning problems, and restless sleep all are significantly more common in habitual snorers, 1,4,10,11 although these studies did not differentiate between children with PS or OSA. Because snoring is so common in children and may resolve over time, 12,13 surgical removal of adenotonsillar tissue (tonsillectomy and adenoidectomy), the first line of treatment, is not currently recommended unless OSA is present. In a study encompassing a relatively small number of children, an apnea/hypopnea index (AHI) of Ͼ5/ hour of total sleep time (hrTST) or an obstructive apnea index (OAI) of Ͼ1/hrTST were suggested to represent the cutoff points for normal subjects.…”

Sleep-disordered breathing in children

“…Es muss nach derzeitigem Wissen nicht behandelt werden. Etwa 10% der Kinder mit PS zeigen jedoch im Verlauf eine Progression hin zu einer relevanten obstruktiven SBAS [32]. …”