This article is very close to home for me — I'm writing it sitting in my 3-year-old son's hospital room while he sleeps after having an Adenotonsillectomy (adenoids and tonsils removed). While this is quite a common procedure, the most common reason these are removed in young children is disrupted sleep and problems breathing. In my son's case, he started breathing through his mouth on a regular basis and became quite tired and cranky during the day.
Warning Signs to Watch For
There are many symptoms for Sleep Related Breathing Disorders (SRBDs) and they should be discussed with your GP or Paediatrician. Major concerns as a parent:
- Your child snores on a regular basis quite audibly — children shouldn't snore without a cold
- Breathing through their mouth rather than their nose, during the day or when sleeping
- Falling asleep or becoming tired and cranky relatively soon after waking
- Trouble breathing during activities, quickly becoming puffed or tired
"It is not unusual or abnormal for children to snore occasionally, such as when they have a cold, but they should not snore most nights, and they should not routinely struggle to breathe or even have to sleep with their mouths open." — Dr Richard Ferber, Solve your Child's Sleep Problems
Behavioural Signs of Poor Sleep
Children who struggle to sleep well can show a range of different behavioural problems during their awake periods. Many children who have been diagnosed with ADHD are not actually hyperactive — they are severely overtired, displaying hyperactivity and difficulty concentrating as a result. Other symptoms of poor sleep include:
- Irritability, forgetfulness, impaired mood
- Short attention span, inability to sit still
- Emotional difficulties, frequent outbursts
- Bedtime battles and difficulty falling asleep
- Excessive daytime sleepiness
- Restless sleeping, sweating at night
- Clumsiness — frequent falls in accomplished walkers
"A child with active sleep patterns was more likely to be described as having symptoms of ADHD — restless or overactive, excitable, impulsive, short attention span, constantly fidgeting, easily distracted…" — Dr Marc Weissbluth, Healthy Sleep Habits, Happy Child
How Enlarged Tonsils and Adenoids Disrupt Breathing
The tonsils are located at the back of our mouth on the sides of our throat. The Adenoids are similar but located at the back of the throat above the roof of the mouth — not visible by looking in. Enlargement of the adenoids can block the normal flow of air through your child's nose, forcing them to breathe through their mouth.
In my son's case: he had a constantly runny nose, was breathing through his mouth day and night, and his tonsils were so large they were almost touching each other. He had behavioural and emotional difficulties — losing his temper at the drop of a hat, demanding and irritable all of the time. 8 weeks after his surgery he is sleeping better and his behaviour and emotional wellbeing is very much improved. He is a much happier little boy.
The Role of Allergies
Allergies are another factor that can impact breathing and sleep. Allergies can cause congestion, runny nose, and difficulty breathing — impacting on the quality of sleep your child gets. If you suspect your child may have an allergy, speak to your GP or Paediatrician for tests and advice.
What to Do If You're Concerned
The biggest thing you shouldn't do is ignore the symptoms or let the doctor brush you off. If you think there is something wrong with your child and you are not taken seriously:
- Document everything
- Get a second opinion, a third opinion
- Push for a referral to an Ear Nose and Throat (ENT) specialist
- Keep going until you are heard
Your Mum intuition is always right. Trust it. The earlier breathing issues are addressed, the better.
Leanne xx