Click here to view next page of this article



Snoring results from the pharyngeal airway collapsing during inspiration. Snoring can disrupt sleep, cause a variety of important but nonspecific symptoms, and suggest the presence of the obstructive sleep apnea syndrome, which can lead to cor pulmonale and sudden death.

snore almost nightly.

Physiologic Sources of the Problem

Snoring and obstructive sleep apnea do not represent structural upper airway narrowing alone, but rather an imbalance between the degree

children deserve surgery or further evaluation. A tracing of respiratory

effort and heart rate (pneumogram) is not helpful because completely obstructed breaths can be missed unless a parameter sensitive to airflow is recorded simultaneously. Many tertiary care centers have sleep laboratories and consultants familiar with the evaluation of sleep and respiratory disorders who can help the pediatrician decide which children might benefit from such "high-tech" assessments. Consultants also may identify children who would benefit from nasal constant positive airway pressure during sleep rather than surgery and can help manage children in whom surgery has not helped resolve symptoms.

Treatment for Pathologic Snoring

Although respiratory stimulants and tricyclic antidepressants have been used to treat obstructive sleep apnea, it rarely is possible to improve pharyngeal muscle tone and function significantly with