In most cases parents do not see snoring as indicative of any underlying disorder and this may be true to a certain extent. However, if the child snores very loudly and has a very disruptive sleep pattern it is best to see a doctor to find out what could be wrong.

Obstructive Sleep Apnea occurs due to a blockage in the upper airway that causes the child to stop breathing briefly while sleeping. The pause in breathing happens several times through the night, disturbing the child’s sleep. Children with the condition tend to snore, sleepwalk, or wet their bed. This condition is common amongst children aged 3 to 6.

Obstructive Sleep Apnea Causes:

When a child falls asleep the muscles in the head and neck that keep the upper airway open, get relaxed and allow the tissues to close in. If the airways are already partially closed while the child is awake, then when they sleep, the airways will get blocked completely leading to Obstructive Sleep Apnea. But what constricts the airways in the first place? In children, the most common cause is swollen tonsils and adenoids. Other known causes include:

• Obesity
• A Tumour
• Certain birth defects such as Down Syndrome and Pierre-Robin Syndrome

Symptoms of Obstructive Sleep Apnea:

• Loud Snoring
• Gasping or snorting during sleep
• Restlessness during sleep
• Mouth breathing while sleeping
• Tired and sleepy during the day
• Hyperactivity
• Morning Headaches
• Bed Wetting
• Sleep Walking

Treating Obstructive Sleep Apnea:

In most cases parents do not see snoring as indicative of any underlying disorder and this may be true to a certain extent. However, if the child snores very loudly and has a very disruptive sleep pattern it is best to see a doctor to find out what could be wrong.

An infection in the tonsils and adenoids could cause them to swell and thereby constrict the upper airways – which is what happens in most cases of Obstructive Sleep Apnea in children. Removing the inflamed or infected tonsils used to be the go-to treatment. However, today that is seldom done. The health care provider will recommend medication based on the cause of the infection and this will help reduce the swelling and resolve the problem.

The doctor might recommend topical nasal steroids to ease symptoms in children with mild Obstructive Sleep Apnea.

When medications and sometimes even the removal of tonsils and adenoids are ineffective doctors recommend continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BPAP), where small machines gently blow air through a tube and mask attached to the child’s nose, or nose and mouth. The machine sends air pressure in the back of the child’s throat to keep the upper airway open. As the child grows this mask and tube must be resized and refitted. Initially the child may find it uncomfortable to use, but gradually he/she will get used to the same and be able to sleep peacefully.

If left untreated, Obstructive Sleep Apnea can have long term effects on the child. Lack of sleep can lead to behavioural disorders and deficient performance academically as well. Eventually it can even lead to cardiopulmonary disease. Hence if you notice symptoms of Obstructive Sleep Apnea in your child, the best thing to do is visit the ENT at the earliest.

Reviewed By:

DR.SAVITHA.A

JUNIOR CONSULTANT – PAEDIATRICS

MBBS, DNB(PAEDIATRICS)