It can however, be quite uncomfortable for the child and may cause a significant problem with dento-facial abnormalities and cardiopulmonary such as pulmonary hypertension and cor pulmonale. Also, several rare but potentially life threatening conditions may be the cause of the nasal obstruction and must be considered in the differential diagnosis. Snoring may be only minor annoyance, however, it may indicate obstructive sleep apnea and it is a symptom that requires investigation. Obstructive sleep apnea is caused by mechanical obstruction in the upper airway. The goals of the evaluation are to determine specific causes of problems, the severity of the obstruction, and the presence of associated medical complications.
Lifelong symptoms suggest congenital malformation or early acquired disease or injury.
The general well-being of the child, including growth and development, must be determined. Pertinent past history include birth trauma, early childhood trauma, previous hospitalizations, medications, and surgical history. Related symptoms must be actively investigated. Sleep history may often reveal loud irregular snoring, restless sleep, abnormal sleep position, and nocturnal mouth breathing. Enuresis may also be present.