The development of snoring and steep related breathing distress from 4 to 6 years in a cohort of Swedish children

Background: Snoring is common among both children and adults and a sign of steep disordered breathing (SDB). Adenotonsillectomy is often the solution offered, although the effect is uncertain. There are also some who say that young children who snore will outgrow it even without treatment. The present investigation compares snoring and co-founding symptoms in parental reports for a cohort of children at age 4 and at age 6 years. Method: A cohort of 4 year old children (615) was investigated with respect to SDB [B. Lofstrand-Tidestrom, B. Thilander, J. Ahlqvist-Rastad, O. Jakobsson, E. HuItcrantz, Breathing obstruction in relation to craniofacial and dental arch morphology in 4 year old children, Eur. J. Orthod. 21 (1999) 323-332]. Each child was given a questionnaire. Those reporting significant symptoms also received a clinical and an orthodontic examination. Forty-eight children were diagnosed with SDB; of these 28 were operated with adenoidectomy and/or tonsillectomy. After 2 years, the same questionnaire was administered and the same children as before were further examined as well as those newly reporting significant symptoms. The results from the two occasions were compared. Results: Eighty-three percent (509) of the original cohort participated. The frequency of snoring had changed from 53 to 46% for the group as a whole (p < 0.05). Significant gender differences in co-founding symptoms were seen. Severity of snoring had changed on an individual basis in half of the cases; some recovered, others got worse. Of the children with SDB at 4 years who were operated, 14/28, did not snore at all, compared to 3/18 of the non-operated (p < 0.05). Conclusion: Children who snore at the age 4 seldom grow out of it by age 6 and still show other signs of steep related distress as well. Surgery does not always cure the snoring, thus postoperative follow-up is important. Since new cases develop during this age period, early intervention is not enough. (C) 2007 Elsevier Ireland Ltd. All rights reserved.