Does Your Child Have
Obstructive Sleep Apnea?

By Debra Jaffe, MD

Sleep apnea means "cessation of breathing" during sleep. We may be familiar with this condition in adults but may not know that the disorder also affects 1 to 10% of all children and, if left untreated, can cause significant health problems.

Obstructive sleep apnea (OSA) is the most common type of sleep apnea in children. Enlarged tonsils and adenoids (structures in the back of the throat and nose) are to blame in the majority of cases. When the muscles in the walls of the throat (pharynx) relax during sleep, the walls collapse and the tonsils and adenoids obstruct the flow of air. Being overweight can also make sleep apnea more likely, but extra weight is a less common cause in children than it is in adults. In some children, the shape of the face, jaw or tongue leads to a blocked airway during sleep. Your child's doctor can tell you more about what's causing your child's sleep apnea.

Symptoms of OSA depend on the child's age. In children younger than 5 years, snoring is the most common complaint. Other nighttime symptoms reported by parents include cessation of breathing, gasping for air, excessive daytime drowsiness, bedwetting, nighttime awakening and poor weight gain. Children 5 years and older may exhibit bedwetting, behavior problems, reduced attention span and poor growth.

Diagnosing
Your child's doctor may refer you to a sleep disorders specialist or to an ear, nose and throat doctor (otolaryngologist). To diagnose sleep apnea, the doctor will ask about your child's health history and sleep habits, and will examine your child. He or she may also use a nasoparyngoscopy (a small telescope placed in the nose to evaluate the size of the adenoids) or recommend an overnight sleep study (polysomnography).

Treating
Treatment depends on your child's age, health and medical history, as well as any underlying conditions. Your child's doctor may suggest one or more of the following:

• Nasal steroids
• Systemic steroids -- for short-term use only
• Antibiotics -- for short-term use only
• Continuous positive airway pressure (CPAP) -- a nose or face mask that delivers steady air pressure during sleep
• A denotonsillectomy -- removal of adenoids and tonsils
• Tracheostomy -- a procedure that places a hole in the windpipe (reserved for severe cases)

Left untreated, OSA can cause learning, development or behavior problems and, in some cases, failure to grow, heart problems and high blood pressure. OSA can also cause daytime sleepiness that can result in personality changes and changes in school performance.

Treatment can help prevent these problems, lessen their severity or help them go away. If you suspect that your child has OSA, consult your child's doctor as soon as possible.

Debra Jaffe, MD, is a board-certified, fellowship-trained pediatric otolaryngologist. She cares for infants and children with ear, nose and throat disorders. She joined the practice of Ellis Webster, MD, and Lon Barrow, MD, with an office location in Loxahatchee. For an appointment, please call 561-793-5077.

Wellington Regional Medical Center, 10101 Forest Hill Blvd. Wellington, FL 33414 (561) 798-8500