Snoring & Sleep Apnea
What is sleep disordered breathing?
Sleep Disordered Breathing (SDB) is a broad term that covers conditions such as snoring and obstructive sleep apnoea (OSA). Snoring alone affects 8-12% of children in Australia and is considered to be the mildest form of SDB. On its own it may not be a problem for your child’s development, however it may indicate a more severe form of SDB, such as OSA. OSA is caused by significant upper airway obstruction, which results in interruption of the normal sleep pattern and potentially a drop in the oxygen levels during sleep. In this form, SDB affects 2-3% of children under the age of 10.
The most common cause of SDB in children is upper airway obstruction from enlarged adenoids and tonsils.
What are the symptoms of sleep disordered breathing?
The symptoms of sleep apnea in children are different to those we commonly see in adults. Whereas in adults the hallmark of OSA is periods of not breathing ('apnoeas') the symptoms in children are less specific and include the following:
- Behavioural disturbance - aggression, hyperactivity, inattention, anxiety, moodiness
- ‘Neurocognitive’ impairment - poor concentration as well as impaired learning, memory and executive functioning (e.g. problem solving)
- Sleep changes - snoring, restless sleep pattern (such as moving around the bed), sweating, unusual sleep positions, dry mouth, bed wetting, daytime sleepiness, morning headaches
- Slow growth
How do you treat sleep disordered breathing in children?
A recent report has found that only 10-15% of children with SDB are being treated. The treatment of choice in most cases of SDB is removal of the tonsils and/or adenoids (read about adenotonsillectomy here). This operation has an excellent cure rate- reported to be up to 95%. Only a small number of children with have persistent symptoms after this operation but is why I follow up all children undergoing adenotonsillectomy after the operation to ensure symptoms have resolved. If not then more investigation is warranted.