European Journal of Pediatrics

, Volume 139, Issue 3, pp 165–171 | Cite as

Children and nocturnal snoring: Evaluation of the effects of sleep related respiratory resistive load and daytime functioning

  • Ch. Guilleminault
  • R. Winkle
  • R. Korobkin
  • B. Simmons
Original Investigations


Twenty-five children, age range 2 to 14 years (mean age=7), were referred to the Stanford University Sleep Disorders Clinic for various clinical symptoms, including excessive daytime somnolence, heavy nocturnal snoring, and abnormal daytime behavior. All children (10 girls and 15 boys) were polygraphically monitored during sleep. No sleep apnea syndrome or oxygen desaturation was revealed. However, each child presented significant respiratory resistive load during sleep associated with electrocardiographic R-R interval and endoesophageal pressure swings. The most laborious breathing occurred during REM sleep. Second degree atrioventricular blocks were also noted. Tonsillectomy and/or adenoidectomy was performed in every case and resulted in a complete disappearance or substantial amelioration of the reported symptoms. Objective evaluation by Multiple Sleep Latency Test and Wilkinson Addition Test confirmed the beneficial effect of surgery.

Key words

Snoring Respiratory resistive load Tonsillectomy Sleep 24 h Holter ECG 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Duron B (1973) Postural and ventilatory functions of intercostal muscles. Acta Neurobiol Exp 33:335Google Scholar
  2. 2.
    Duron B, Marlot D (1980) Respiratory muscles in unrestrained cats. Sleep 3:269–280PubMedGoogle Scholar
  3. 3.
    Carskadon MA, Dement WC (1979) Effects of total sleep loss on sleep tendency. Percept Mot Skills 48:495–506PubMedGoogle Scholar
  4. 4.
    Carskadon MA, Harvey K, Duke P, Anders TF, Iris FL, Dement WC (1980) Sleep 2:453–460PubMedGoogle Scholar
  5. 5.
    Guilleminault C, Dement WC (eds) (1978) Sleep Apnea Syndromes. A. R. Liss, New YorkGoogle Scholar
  6. 6.
    Guilleninault C, Eldridge F, Simmons F, Dement WC (1976) Sleep apnea in eight children. Pediatrics 58:23–30PubMedGoogle Scholar
  7. 7.
    Kravath RE, Pollak CP, Borowiecki B (1977) Hypoventilation during sleep in children who have lymphoid airway obstruction treated by nasopharyngeal tube and tonsillectomy and adenoidectomy. Pediatrics 59:865–872PubMedGoogle Scholar
  8. 8.
    Orem J, Netick A, Dement WC (1977) Increased upper airway resistance to breathing during sleep in the cat. Electroencephalgr Clin Neurophysiol 43:14–22Google Scholar
  9. 9.
    Pengelly LD, Rebuck AS, Cambell EMG (1975) Loaded Breathing. Proceedings of an international symposium. C. Livingstone, EdinburghGoogle Scholar
  10. 10.
    Sullivan CE (1981) Breathing in sleep. In: Orem J, Barnes CD (eds) Physiology in sleep. Academic Press, New York, p 213Google Scholar
  11. 11.
    Tanner JM (1962) Growth in adolescence, 2nd ed. Oxford-Blackwell, OxfordGoogle Scholar
  12. 12.
    Tassinari CA, Dalla-Bernadina B, Cirignotta F, Ambrosetto G (1972) Apnoeic periods and the respiratory related arousal patterns during sleep in the Pickwickian Syndrome: a polygraphic study. Bull Physio-Pathology Resp 8:1087–1102Google Scholar
  13. 13.
    Tikian A, Guilleminault C, Schroeder J, Lehrman K, Simmons F, Dement WC (1977) Sleep induced apnea syndrome: prevalence of cardiac arrhythmias and their reversal after tracheostomy. Am J Med 63:348–358PubMedGoogle Scholar
  14. 14.
    Wilkinson R (1960) Sleep deprivation: performance tests for partial and selective sleep deprivation. In: Abt L, Riess B (eds) Progress in clinical psychology, vol. 8. Greene and Stratton, New YorkGoogle Scholar

Copyright information

© Springer-Verlag 1982

Authors and Affiliations

  • Ch. Guilleminault
    • 1
  • R. Winkle
    • 2
  • R. Korobkin
    • 1
  • B. Simmons
    • 3
  1. 1.Sleep Disorders Clinic--TD-114Stanford University Medical CenterStanfordUSA
  2. 2.Division of Cardiology Stanford University Medical CenterUSA
  3. 3.ENT Division Stanford University Medical CenterUSA

Personalised recommendations