Medical expert of the article
New publications
Snoring with adenoids in children and adults
Last reviewed: 12.07.2025
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
Adenoids (adenoid vegetation) are enlarged pharyngeal or nasopharyngeal tonsils that look like folds and are part of the innate immune system – the lymphoepithelial pharyngeal ring. When these folds increase, such a symptom of respiratory failure as snoring with adenoids occurs.
Epidemiology
According to European pediatricians, snoring occurs in 15-20% of children under 13 years of age (the peak is observed in children from 2 to 8 years of age). [ 1 ]
According to the American Academy of Family Physicians, the estimated prevalence of snoring in children ranges from 3 to 35%. Boys (12.4%) snore more often than girls (8.5%). In most cases, snoring is a consequence of hypertrophy of the adenotonsillar tissue. [ 2 ]
Snoring due to adenoids in adults affects people aged 18-25 in 60% of cases, and more than two-thirds of them are men. [ 3 ]
Causes snoring with adenoids
The main causes of snoring with adenoids are vibration of the increased mass of soft lymphatic tissue located in the nasopharynx: on its upper and back walls. That is, blocking the nasopharyngeal canal by adenoids leads to its narrowing and increased resistance of the upper respiratory tract to the flow of inhaled (and exhaled) air, and snoring occurs with adenoids in children. [ 4 ]
The pharyngeal (adenosic) tonsil is formed during embryonic development by subepithelial infiltration of lymphocytes of the mucous membrane of the distal part of the nasopharyngeal vault. After birth, the tonsil continues to expand and lengthen until the age of six to seven years, when the lymphoepithelial pharyngeal ring is fully formed, protecting the mucous membranes of the respiratory tract from infections.
Why the nasopharyngeal tonsil can grow pathologically in childhood is described in detail in the publications:
Then (from the age of nine to ten) the accumulation of lymphoid tissue in the nasopharynx begins to gradually decrease, and in adults its complete involution occurs. Therefore, snoring due to adenoids in adults is very rare. The most common causes of adenoid hypertrophy in adults are chronic infection and allergy (chronic allergic rhinitis). See - Adenoids in adults. [ 5 ]
Risk factors
Hypertrophied (enlarged) adenoids can become large enough to completely block airflow through the nasal passages, forcing the child to breathe through the mouth. This is a major risk factor for snoring.
In adults, important predisposing risk factors for adenoid hypertrophy and associated ronchopathy include smoking, air pollution with harmful substances (in industrial premises), as well as malignant neoplasms of the nasopharyngeal localization and HIV infection.
Pathogenesis
The mechanism of snoring is discussed in detail in the material – Snoring.
The pathogenesis of adenoid hypertrophy is associated with their frequent acute inflammation – adenoiditis, caused by viruses. In cases of chronic inflammation, the most common infection is Staphylococcus aureus. Adenoids can also increase in size with frequent nasopharyngitis and chronic allergic rhinitis. [ 6 ]
The tissues of the hypertrophied nasopharyngeal tonsil consist of pseudostratified epithelium cells altered by inflammatory processes, with an increased number of overgrown basal layer cells, macrophages and interepithelial lymphocytes – in the form of diffuse lymphoid tissue zones localized among epithelial cells. In the lymphoid tissue of the adenoids itself, there are newly formed lymphoid nodules and larger secondary lymphatic follicles. In addition, in certain areas of the tonsils there are depressions (crypts) that contain the decay products of epithelial cells and lymphocytes.
Read also – Tonsil hyperplasia
Symptoms snoring with adenoids
In addition to nasal congestion, difficulty breathing through the nose and snoring, with stage 3 adenoids, a child exhibits symptoms such as dizziness and frequent headaches, a nasal voice, swollen cervical lymph nodes, hearing loss (due to frequent otitis) and the formation of the so-called “adenoid face” - with an open mouth (due to constant breathing through the mouth) and a lowered lower jaw (an increase in the angle of its plane), which leads to deformation of the dental arch and facial skeleton. [ 7 ]
Complications and consequences
Complications of snoring due to hypertrophy of the pharyngeal tonsil:
- restless sleep;
- strained or noisy breathing (stridor);
- sleep apnea syndrome (pauses in breathing), which is observed in 2-3.5% of children with adenoids;
- daytime sleepiness. [ 8 ]
Difficulties arise in breastfeeding infants with adenoids. [ 9 ]
Diagnostics snoring with adenoids
In addition to collecting anamnesis and physical examination, diagnosis of adenoid hypertrophy includes general blood and urine tests, bacterial culture of the nasopharynx microflora, and in adults (if necessary) a biopsy of adenoid tissue and its histological examination.
Instrumental diagnostics are carried out for the purpose of examining the pharynx, for which ENT specialists use rhinoscopy (including endoscopic), pharyngoscopy, lateral nasopharyngeal radiography or CT of the nasopharynx.
Differential diagnosis
To exclude benign tumors of the nasopharynx (Tornwalds cyst or juvenile nasopharyngeal angiofibroma), teratoma or nasopharyngeal carcinoma, differential diagnostics are performed.
Who to contact?
Treatment snoring with adenoids
Adenoids are treated with conservative methods and physiotherapy, all methods are in the materials:
How to eliminate snoring with adenoids of 2 and 3 degrees? Today, the only real relief from snoring caused by the proliferation of lymphoid tissue of the pharyngeal tonsil is the removal of adenoids in children - adenoidectomy. If there are appropriate indications, adenoidectomy is performed at any age. [ 10 ]
Read also – Laser adenoid removal surgery.
According to clinical data, in 19-26% of cases after surgery, the pharyngeal tonsil grows back with repeated hypertrophy, and in such situations, snoring is possible after adenoid removal. [ 11 ]
Prevention
Full information in the material – Prevention of adenoids in children.
Forecast
With timely adenoidectomy, the prognosis is positive, since the cause of snoring is eliminated.