Podcast Summary: The Pediatrician Next Door

Episode 144: When is Snoring a Problem?
Host: Dr. Wendy Hunter
Guest: Dr. Shirin Lim
Release Date: December 3, 2025

Episode Overview

In this episode, Dr. Wendy Hunter dives into a surprisingly complex topic: childhood snoring. Is it just a harmless noise or a red flag for deeper health issues? Featuring sleep medicine expert and dentist Dr. Shirin Lim, the conversation explores how snoring in children can signal sleep-disordered breathing, affect behavior, learning, and even facial development, and lays out practical steps for parents who are concerned.

Key Discussion Points & Insights

What Happens When We Snore?

• Snoring basics: Snoring is caused by the vibration of something in the airway, usually due to a blockage. In children, this often results from large tonsils, allergies, or issues with jaw and tongue positioning.
  • Dr. Wendy Hunter: "Snoring means something is vibrating in the airway, usually because it's blocked." (03:20)
• Allergies & airflow: Treating nasal allergies is often the first step since swelling can contribute to snoring.
  • "That's why sometimes the first treatment is to treat nasal allergies...if it works, great." (03:49)
• Impact of blockage: Airway narrowing can disrupt sleep without easy-to-see awakenings; sleep studies may reveal many micro-awakenings.
  • "Some kids have multiple awakenings, but you can't actually see them with your own eyes." (04:34)
• Consequences: Poor sleep from snoring affects learning, growth, and emotional regulation in kids.

Snoring as a Clue to Bigger Problems

• Common but not always harmless: Most kids snore occasionally, but frequent snoring can signal sleep-disordered breathing, which has widespread effects.
• Unusual symptoms: Bedwetting, stalled speech therapy progress, and frequent nighttime awakenings can be linked to sleep-breathing trouble.
  • Dr. Shirin Lim: "Bedwetting is another key red flag that a child is not breathing well." (05:31)
• Behavioral confusion: Unlike sleep-deprived adults, children with poor sleep may appear "wired" or hyperactive, not just tired.
  • "They never seemed tired. Actually, they are more likely wired...these kids can look hyperactive." – Dr. Wendy (07:31, 08:11)
• Misdiagnosis risk: Children are sometimes misdiagnosed with ADHD or given sleep drugs when the root cause is breathing issues.

Airway Health: The Overlooked Pillar

• Health professional blindspots: Most providers focus on sleep routines and quantity, not quality or breathing.
  • Dr. Lim: "There's really an under recognition...We're really not taught to check. How are they breathing? What is the quality of their sleep?" (09:22)
• Fragmented care: Symptoms like bedwetting or teeth grinding may be treated separately without recognizing a shared root cause.
  • "Healthcare is really set up to deal with symptoms...but really we need to pull together to really ask what is the root issue?" – Dr. Lim (10:40)

How Can Parents Spot Problematic Snoring?

• Signs parents should watch for:
  • Snoring most nights (when not sick)
  • Mouth breathing during sleep and day
  • Sweating or excessive movement at night
  • Observed gasping, choking, or pauses in breathing
  • Teeth grinding (a key red flag!)
  • Dr. Lim: "Teeth grinding is the strongest red flag inside the mouth that a child is not breathing well." (12:22)
• Behavioral clues: Hyperactivity, emotional outbursts, or poor school performance.

When Is Snoring a Problem?

• Frequency matters:
  • Dr. Wendy: “If your child snores more than three nights a week when they're not sick, it's worth looking into.” (15:18)
• First steps: Start by observing your child’s sleep—record short clips if needed for your pediatrician.

Which Specialist to See?

• Your pediatrician is the usual first stop (and will often recommend treating nasal allergies as a first try).
• ENT (Ear, Nose, Throat) specialists check for anatomical issues—like enlarged tonsils/adenoids.
• Dentists/Orthodontists can address jaw and airway growth; palate expansion may improve airway and reduce issues from crowded teeth or narrow jaws.
  • Dr. Lim: “If their jaws aren't growing fully, we can have orthodontic problems like crooked teeth...these can be red flags.” (20:18)
• Myofunctional therapists help retrain oral muscles for better tongue posture and nasal breathing.
  • "Myofunctional therapists are people that actually work with the muscles of the mouth and face to actually restore normal patterns..." – Dr. Lim (25:55)
• Other providers might also help, e.g., allergists, osteopaths, chiropractors, or breathing retrainers in complex cases.
  • "It involves a team approach." – Dr. Lim (27:10)

Why Early Treatment Matters

• Facial and airway development: Mouth breathing and low tongue posture can change jaw growth, narrow the airway and palate, and contribute to long-term dental and breathing issues.
  • "The tongue is really the main upper airway dilator muscle...any oral dysfunctions...are markers that there’s going to be problems." – Dr. Lim (21:28)
• Improved outcomes: Addressing the root causes early gives the body a chance to develop normally and can help with sleep, learning, and behavior.

Memorable Quotes & Timestamps

• On snoring and irritation (humor):
  • Dr. Wendy: “Have you ever wanted to put a pillow over your partner’s head because they were snoring?” (00:54)
• On what snoring means:
  • Dr. Wendy: “Snoring means something is vibrating in the airway, usually because it’s blocked.” (03:21)
• On bedwetting as a sign:
  • Dr. Lim: "Bedwetting is another key red flag that a child is not breathing well." (05:31)
• On teeth grinding:
  • Dr. Lim: "Teeth grinding is the strongest red flag inside the mouth that a child is not breathing well." (12:22)
• On overlooked symptoms:
  • Dr. Wendy: “Sometimes fine is just a kid who’s gotten really good at running on fumes.” (08:39)
• On jaw and airway growth:
  • Dr. Lim: “If their jaws aren’t growing fully, we can have orthodontic problems...they’re all symptoms that the jaws aren’t growing well.” (20:18)
• On treatment as a team approach:
  • Dr. Lim: “There’s a lot of different other professionals that we can work in collaboration… It involves a team approach.” (27:18)

Practical Advice & Takeaways

• Observe your child’s sleep regularly
  • Listen for frequent snoring, mouth breathing, unusual movements, or teeth grinding.
  • Record short video clips for your doctor if needed.
• Frequency matters:
  • Snoring over three nights a week (when not sick) is worth evaluation.
• Behavioral and emotional issues (hyperactivity, poor focus, emotional outbursts) could be linked to sleep-breathing issues.
• Seek a team approach—don’t be satisfied with just suppressing symptoms; seek providers who look at airway health holistically.
• Early intervention can prevent bigger issues in growth, facial development, and learning.

Timestamps for Key Segments

| Timestamp | Segment | |-----------|-------------------------------------------------| | 00:54 | Dr. Wendy introduces pediatric snoring problem | | 03:21 | Explanation of snoring mechanisms | | 05:31 | Dr. Lim on bedwetting and breathing | | 07:01 | Subtle & overlooked signs of sleep disturbance | | 09:22 | Dr. Lim on under-recognition in healthcare | | 12:22 | Teeth grinding as a key red flag | | 13:45 | Dr. Wendy’s checklist for parents | | 15:18 | Rule of thumb: snoring more than 3 nights/week | | 20:18 | Facial/jaw development and airway health | | 23:47 | Dr. Lim on treatment options and myofunctional therapy | | 27:18 | Team approach to airway health |

Final Word

If your child snores often, don’t ignore it. What seems like a small annoyance may be a clue to much bigger health mysteries—ones that can be solved with attention, teamwork, and timely care. As Dr. Wendy says:

"Take a moment, listen, maybe record it. Because that sound might be the first clue in a mystery that only you can solve." (27:52)

For further reading:

• Dr. Shirin Lim’s book: Breathe, Sleep, Thrive (link in episode show notes)

Have more questions?
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