Red Flags for Sleep Disordered Breathing in Children

sleep disordered breathing

Red Flags for Sleep Disordered Breathing in Children

sleep disordered breathing

Most parents don’t realise that the way a child sleeps can reveal how well they’re breathing, whether their airway is functioning properly, and how their jaw and facial structures are developing.

Snoring, restless sleep, night waking or strange sleep positions often get brushed off as “normal kid things” — but they are major clues pointing to sleep disordered breathing (SDB).
Sleep disordered breathing includes:
• chronic mouth breathing
• nasal obstruction
• sleep apnoea
• poor oxygenation
• airway resistance

Left untreated, sleep disordered breathing affects:

  • jaw and facial development
  • dental crowding and bite problems
  • behaviour, attention & emotional regulation
  • growth & immunity
  • feeding and chewing
  • school performance

The good news? Children respond incredibly well to early intervention, especially when we support airway, breathing, tongue posture and oral habits early.

Below are the key red flags, why they matter, and when to seek help.

1. Mouth Breathing (Day or Night)

Healthy breathing always happens through the nose.
Lips together. Tongue resting on the palate. Quiet breathing.

When a child mouth breathes:

  • the airway dries out
  • the tongue rests low
  • the palate narrows
  • teeth crowd
  • the jaw grows downward
  • risk of cavities increases
  • oxygen levels can drop during sleep

Red flags:
• mouth open during sleep
• drooling on the pillow
• cracked/dry lips
• chronic congestion

Important: Mouth breathing is never “just a habit.”
There is always a reason.

2. Snoring (Even Soft or “Cute” Snoring)

Snoring = airway resistance.
Even mild snoring means a child is working too hard to breathe.

Red flags:
• snoring more than 1–2 nights per week
• pauses or gasps
grinding teeth
• night sweats

Grinding is especially important — it is often a sign the body is trying to open a restricted airway.

3. Restless, “Wild” or Unusual Sleep Positions

When breathing is disrupted, the body works overtime to compensate.

Children may:
• toss and turn
• kick blankets off
• move constantly
• sleep in odd postures

Airway-compensation positions:
• bum up in the air
• neck arched back
• curled up tightly
• sleeping upright or propped

These positions mean the body is trying to find more airflow.

4. Behaviour & Learning Concerns

One of the most overlooked signs of sleep disordered breathing is daytime behaviour.

Low oxygen overnight can look like:
• hyperactivity
• impulsiveness
• emotional volatility
anxiety
• poor concentration
• sensory overwhelm

Many children assessed for ADHD have underlying airway or oxygenation issues.
Morning fatigue or difficulty waking is also a major clue.

5. Feeding & Chewing Difficulties

Children with airway issues often struggle with chewing because the tongue, palate and jaw aren’t functioning optimally.

Red flags:
• preference for soft foods
• gagging or choking
• avoiding chewy textures
• long-term reliance on pouches
• fatigue during meals

This often connects back to tongue tie, low oral tone or a narrow palate — the same issues that contribute to poor night-time breathing.

6. Large Tonsils/Adenoids or Chronic Congestion

If a child can’t breathe through their nose, their airway is already compromised.

Common causes:
• allergies
• inflammation
• enlarged adenoids or tonsils
• mould exposure
• tongue posture problems
• restricted jaw growth
• recurring colds

A child who mouth breathes during the day will mouth breathe at night.

7. Delayed Feeding, Speech or Oral-Motor Milestones

Oral function and airway growth are deeply connected.

Red flags:
• messy eating
• difficulty transitioning to textured foods
• speech articulation challenges
• tongue thrust
• open-mouth posture
• delayed chewing skills

These often relate to tongue tie, low oral tone, or airway structure — all of which affect breathing during sleep.

How We Support Children With Sleep Disordered Breathing

Our approach looks at the whole child, not one isolated symptom.

We assess:
• nasal patency
• mouth vs nose breathing
• tongue posture & mobility
• jaw/palate shape
• sleep behaviours
• feeding history
• oral habits
• nutrient & inflammation status
• microbiome patterns
• environmental factors (dust mites, mould, allergens)

This allows us to create a personalised, gentle and effective plan.

Our Support May Include:

✔ Clearing airway obstructions

Holistic strategies for inflammation, congestion, allergy load, nasal blockage and mouth breathing habits.

✔ Tongue-tie assessment & oral-motor therapy

Supporting tongue posture strengthens the airway and restores nasal breathing.

✔ Jaw & palate development support

Early, child-friendly approaches to widen the palate and improve airflow.

✔ Feeding strategies to build chewing strength

Texture progression, chewing exercises, and feeding support for airway development.

✔ Sleep environment optimisation

Light, allergens, humidity, routines and nervous system support.

When to Seek Help

If your child has even ONE of the following:
• snoring
• mouth breathing
• restless sleep
• unusual sleep positions
• night sweats
• behavioural challenges
• chronic congestion
feeding difficulties
• dark circles
speech delay
• frequent gagging
• open-mouth posture

…it’s time for a gentle, thorough assessment.

Early intervention is powerful.
The earlier we support the airway, the easier it is to improve behaviour, sleep, jaw growth and overall wellbeing.

Make an appointment with Natalie our Naturopath and Oral Myofunctional Therapist

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