Doctors often use the term adenotonsillar hypertrophy to describe enlarged adenoids and tonsils. Sometimes, they become so large that they partially block, or obstruct, the upper breathing passage and interfere with normal breathing. This can lead to labored breathing, choking sensations, gasping or snorting noises, and may contribute to sleep-disordered breathing (SDB). Enlarged tonsils and adenoids are the most common causes of SDB.¹

Sleep-disordered breathing

Sleep-disordered breathing is a range of disorders that includes snoring, shallow breathing, breathing pauses, and, in extreme cases, obstructive sleep apnea (OSA). The most common symptom of SDB is loud snoring during the night. There are many muscles in the throat that keep the upper breathing passage open. During sleep, these muscles relax and move closer to each other, narrowing the airway to create turbulence and cause the vibrating sound associated with snoring. The most effective treatment for SDB in children is tonsillectomy/adenoidectomy.^1,2

What to look for

Here are some of the symptoms associated with sleep-disordered breathing:

• Breathing pauses
• Restless sleep
• Frequent nighttime awakening or arousal
• Daytime fatigue or over activity
• Bedwetting

Sleep apnea

Sleep apnea is a sleep-disordered breathing (SDB) problem that can lead to other health and behavior problems. The word apnea means stoppage of breath. Sleep apnea is a sleep-disordered breathing problem that causes a person to have multiple breathing pauses during sleep. In severe cases, difficult breathing caused by sleep apnea can lower blood oxygen levels, and if the problem persists, stress the heart and lungs. Children with sleep apnea may be tired and irritable, lack energy, and have difficulty concentrating. Some experts believe that sleep apnea in children can contribute to attention-deficit/hyperactivity disorder, excessive daytime sleepiness, and failure to thrive—a term used to describe infants and children whose growth rate or weight gain are substantially below normal.^1,2

What to look for

Many of the common signs and symptoms of sleep apnea are the same as those for SDB, but to a greater degree.

• Nightly snoring
• Gasping for air during sleep
• Irregular breathing during sleep
• Mouth breathing
• Restlessness during sleep
• Excessive daytime sleepiness or irritability
• Daytime irritability
• Daytime hyperactivity