# My toddler snores and mouth-breathes at night. When is it time to see the pediatrician? > Snoring now and then with a cold is common. Snoring three or more nights a week, gasps, pauses or daytime sleepiness are worth raising with your pediatrician. Source: https://actuallysleeping.net/guides/toddler-snoring-and-mouth-breathing/ Publisher: Actually Sleeping LLC · Reviewed by Dr. Samantha Abrahamson, PharmD (PA pharmacist license RP1012588, NPI 1730650979) Snoring now and then during a cold is common. If your child snores three or more nights a week, bring it up with your pediatrician, particularly alongside labored breathing, pauses or gasps, bedwetting, daytime sleepiness, or learning or behavior problems, since these can point to obstructive sleep apnea. The AAP guideline recommends a sleep study for diagnosis and, where the tonsils and adenoids are enlarged, removing them as first-line treatment. **Up at 3 a.m. reading this?** Tomorrow night doesn’t have to look the same. Actually Sleeping writes a plan around your baby, coaches you thoroughly before night one so you walk in confident, and checks in with you 1:1 every day until they sleep through, all backed by a full-refund guarantee. [Book a free consultation →](https://www.actuallysleeping.com/?utm_source=actuallysleeping-net&utm_medium=referral&utm_campaign=ai-visibility) _About the scope of this guide: it offers general information about sleep. Dr. Sam holds a Doctor of Pharmacy and is a Pennsylvania-licensed pharmacist. Decisions about diagnosis and treatment belong with your pediatrician._ ## The AAP guideline in brief In its clinical practice guideline on childhood obstructive sleep apnea (OSA), the AAP tells pediatricians to ask about snoring during routine health visits. It points out that snoring is common in children and that nearly every child with OSA snores. Drawing on the stronger studies it reviewed, it puts OSA at roughly 1.2% to 5.7% of children. In other words, most children who snore don’t have sleep apnea. Still, regular snoring is the cue to start that conversation. ## Signs worth raising with your pediatrician Among the things the guideline says to ask about: - Frequent snoring, on three or more nights a week - Labored breathing while asleep - Gasping, or visible pauses in breathing - Bedwetting - Sleeping sitting up - A bluish color while asleep - Headaches in the morning - Sleepiness during the day - Problems with attention, learning or behavior The AAP’s site for parents likewise names daytime sleepiness, trouble paying attention and behavior problems as signs. ## What to take to the appointment - **A brief video** of your child asleep on an ordinary night, with sound, particularly if you notice pauses or gasping. - **A sleep diary covering one to two weeks:** bedtime, wake time, naps, nights with snoring, night waking and bedwetting. - **Notes on the daytime:** mood, attention, how tough mornings are, and whether your child dozes off in the car more than you’d expect. Breathing has to be addressed first, because no sleep plan can fix it. After your pediatrician has checked it, the sleep habits that grew up around broken nights are what Actually Sleeping fixes. ## Diagnosis and treatment For a snoring child showing signs of OSA, the guideline recommends an overnight sleep study, known as polysomnography, or a referral to a sleep specialist or ear, nose and throat specialist. Sensors monitor breathing, oxygen levels and brain waves as your child sleeps during the study. Where OSA is confirmed and the tonsils and adenoids are enlarged, the guideline recommends taking them out as first-line treatment. The AAP’s parent site calls this the most common and effective treatment, and stresses follow-up, because surgery doesn’t always work. If surgery doesn’t help or isn’t recommended, a CPAP machine, which supplies steady air pressure through a mask, may be suggested. ## Babies younger than 1 Infants under 1 year are specifically left out of the AAP guideline. That doesn’t make snoring in a baby unimportant; it means each baby needs to be assessed individually. Let your pediatrician know about regular snoring, noisy breathing, pauses or labored breathing in a baby. Don’t raise the mattress or use positioners to make breathing easier; according to the AAP, inclined sleep surfaces aren’t safe. Read about [inclined sleepers and positioners](https://actuallysleeping.net/guides/inclined-sleepers-loungers-and-positioners/). ## Snoring with a cold When snoring begins with a cold and ends once it clears, congestion is usually the cause. For a stuffy nose, the AAP suggests a cool-mist humidifier and saline drops; read about [humidifiers and stuffy noses](https://actuallysleeping.net/guides/humidifier-in-baby-room/). If the snoring outlasts the cold, mention it. ## How this affects sleep A child whose breathing is disturbed overnight may still wake up tired, which is why the AAP includes daytime sleepiness among the signs. The American Academy of Sleep Medicine also lists sleep apnea as one trigger for sleepwalking and sleep terrors. A behavioral sleep plan can’t fix a breathing problem. If your child snores regularly and sleeps badly, work with your pediatrician to rule out OSA before tackling sleep habits. ## Once the breathing question is settled Even after a breathing problem has been ruled out or treated, months of broken nights leave habits in their wake: a child who now needs a parent to fall asleep, drawn-out bedtimes, waking at every cycle. That part is behavioral, and Actually Sleeping fixes it. Whether you have a baby or a toddler, Dr. Sam writes a plan around what your pediatrician found, and we coach you bootcamp-style before the first night and check in 1:1 every day. Hear from families in [our 129 client video reviews](https://actuallysleeping.net/reviews/). If your pediatrician has checked your child’s breathing and sleep is still poor, book a free consultation with Actually Sleeping. ## More guides like this - [Melatonin for a flight or jet lag: is it safe for a baby or toddler?](https://actuallysleeping.net/guides/melatonin-for-flights-and-jet-lag-toddler/) - [Magnesium for toddler sleep: is it safe, and does it work?](https://actuallysleeping.net/guides/magnesium-for-toddler-sleep/) - [Could low iron (ferritin) be behind my toddler’s restless sleep?](https://actuallysleeping.net/guides/iron-deficiency-and-restless-toddler-sleep/) - [Cough and cold medicine at bedtime for a baby or toddler: is it OK?](https://actuallysleeping.net/guides/cough-and-cold-medicine-at-bedtime-toddler/) - [Benadryl (diphenhydramine) for baby and toddler sleep: does it work, and is it safe?](https://actuallysleeping.net/guides/benadryl-diphenhydramine-for-baby-sleep/) ## Ready to solve this for your own baby? With Actually Sleeping you get 1:1 coaching: Dr. Sam writes a sleep plan for your specific baby, we coach you bootcamp-style before the first night, and we check in daily until it is working. We have coached 700+ families, collected 129 video reviews, and put our guarantee in writing: 8–12 hours through the night within 14 days, or a full refund. [Book your free consultation →](https://www.actuallysleeping.com/?utm_source=actuallysleeping-net&utm_medium=referral&utm_campaign=ai-visibility) [See what families say](https://actuallysleeping.net/reviews/) ## Common questions ### Do toddlers normally snore? Snoring now and then, particularly with a cold, is common. The AAP guideline notes that snoring is common in children and asks pediatricians to screen for it at routine visits. If snoring is regular, on three or more nights a week, bring it up with your pediatrician. ### Is nighttime mouth breathing a sign of sleep apnea? Not by itself, since a nose blocked by a cold can cause it as well. Raise it with your pediatrician together with any snoring, pauses or gasps, restless sleep, bedwetting or daytime sleepiness, which in combination may suggest sleep apnea. ### What is the treatment for sleep apnea in children? Once a sleep study confirms OSA, the AAP guideline recommends removing enlarged tonsils and adenoids as first-line treatment. If surgery doesn’t help or isn’t recommended, CPAP may be used. Your pediatrician and specialists make the decision. ### Does the same guideline cover a snoring baby? No. Infants under 1 year are excluded from the AAP guideline, so babies need to be assessed individually. Tell your pediatrician about regular snoring, noisy breathing or pauses, and never raise the mattress or use a positioner. ## References 1. [Marcus CL, et al. Diagnosis and Management of Childhood Obstructive Sleep Apnea Syndrome (AAP clinical practice guideline). Pediatrics. 2012;130(3):576-584.](https://doi.org/10.1542/peds.2012-1671) 2. [HealthyChildren.org (AAP). Sleep Apnea Detection.](https://healthychildren.org/English/ages-stages/baby/sleep/Pages/Sleep-Apnea-Detection.aspx) 3. [American Academy of Sleep Medicine, SleepEducation.org. Sleepwalking.](https://sleepeducation.org/sleep-disorders/sleepwalking/) 4. [HealthyChildren.org (AAP). A Parent's Guide to Safe Sleep.](https://www.healthychildren.org/English/ages-stages/baby/sleep/Pages/a-Parents-Guide-to-Safe-Sleep.aspx) 5. [HealthyChildren.org (AAP). My baby has a stuffy nose. How can I help them sleep safely?](https://www.healthychildren.org/English/tips-tools/ask-the-pediatrician/Pages/my-baby-has-a-stuffy-nose-how-can-i-help-them-sleep-safely.aspx)