The impacts of snoring can be far more serious than just sleepless nights, a leading Australian doctor warns.
Poor behaviour, learning difficulties, and long-term problems can all stem from obstructive sleep apnoea - and snoring more than three times a week is a key sign that something more serious could be up, Dr Irene Bomba said.
The Australian orthodontist, who works in the sleep clinic at Prince of Wales Hospital in Sydney, was one of the guest speakers at the New Zealand Association of Orthodontists Conference in Rotorua this week.
One of the topics was the problems caused by obstructive sleep apnoea, especially in children, and the role of orthodontists in helping to diagnose and treat the problem.
It's believed it affects about one in 25 New Zealand men and one in 50 New Zealand women and children. Maori are four times more likely to be affected.
Dr Bomba said her real focus was on better educating the medical profession to take the problem seriously.
"We can really change these people's lives. I'd like to eliminate it in adults."
She believed about 35 per cent of children who snored more than three times a week had obstructive sleep apnoea.
Weight and environmental factors like allergies could increase the risk, she said.
"If a child is snoring more than three nights a week then parents should be concerned."
She said if sleep apnoea went untreated as well as behavioural and learning problems it could cause problems in the muscle and skeletal structure of the face.
Fellow speaker Dr Gillian Nixon, a paediatrician at Monash Children's Hospital, said obstructive sleep apnoea was a "big problem" in New Zealand.
She said often parents weren't too concerned about snoring but it could be a sign of bigger problems which was why it was important to have it diagnosed and treated.
"If parents feel that their child is having difficulty breathing while asleep or are worried they are not getting enough air, then those are worrying signs that the child might have obstructive sleep apnoea. Because the breathing problem leads to sleep disturbance, children often have difficulty concentrating during the day and are more likely to have behaviour problems, temper tantrums and moodiness."
She believed in many cases it was being picked up too late and because of that problems like behavioural issues remained after the treatment because they were so entrenched.
"The earlier it can be diagnosed and treated, the best chance there is of improving the consequences."
Dr Nixon said orthodontists had an important role to play.
"Children with nasal obstruction [leading to snoring, sleep apnoea and daytime mouth breathing] can develop changes in the shape of the face that results in problems with the alignment of teeth."
She said in some cases parents might not be aware breathing was an issue and the first profession they might see could be an orthodontist.
"Orthodontists have an important role in asking about snoring and breathing problems during sleep and referring children to their doctor for tests and treatment where there is concern."