Just get the adenoids out. They are, indeed, a problem for your kid, and they may be causing sleep apnea.

I would get a sleep study. They're not that bad and they're the only way to know for sure.

Ask dentist about his palate. My kid had a high palate and it caused speech problems and sleep problems. Had an expander (around age 8-9) and both issues got much better.

I would go to a different ENT and ask what they think. Mouthbreathing is a red flag and “dreaming a lot” means that he is waking up in the middle of his REM cycle. We always dream but we usually don’t remember our dreams unless our sleep is disrupted.

I am a cult that has had multiple sleep studies. They are awful and for my first one, I slept about 1 hour. Don’t do this to your kid.

Have you gotten a second opinion on the issue? Do that. Sleep is essential to young children, so if a doc says removal could help. Just do it. My kid had tonsils and adenoids removed when they were four. Totally fine.

My 4yo is a very active sleeper. Wakes multiple times a night. Seems like he’s dreaming a lot. He used to snore but I don’t think he does now, although he does mouth breathe. I don’t notice any gasping for air. I wonder whether this is likely to be apnea or whether it could be something else, especially given all the dreaming. Maybe his mind is just racing? What else could cause active sleep besides apnea?

Note that we know he has somewhat enlarged adenoids but borderline as to whether they should be removed. Really up to me. Never had a sleep study, and while I hear they’re terrible at this age, I kind of want one to know whether it’s actually apnea. I don’t want to have his adenoids removed if they’re not actually causing the issue.