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Snoring and Obstructive Sleep Apnoea (OSA) in Children

Obstructive Sleep Apnoea (OSA) is an emerging public health problem. Snoring may be the first symptom of OSA. Children with sleep apnoea have breathing difficulties while they are asleep. It is caused by partial or complete obstruction of the airway during sleep. Four in every 100 children will experience some form of OSA.

What are the symptoms of OSA?

  • Snoring
  • Apnoeas (pauses in breathing)
  • Choking/gagging in sleep
  • Restless sleep/frequent waking up
  • Mouth breathing
  • Cough/vomit in sleep
  • Excessive sweating
  • Wakes up unrefreshed
  • Morning headache
  • Excessive daytime tiredness/sleepiness
  • Behavioural issues and impaired concentration at school

What are the causes of OSA?

  • Large tonsils and adenoids
  • Chronic nasal allergies
  • Congenital abnormalities of the jaw, palate, nose, throat, airways
  • Orthodontic issues
  • Neuromuscular diseases
  • Obesity
  • Some syndromes and genetic disorders (Down syndrome, Pierre Robin Sequence, Prader Willi)

Why is it important to treat OSA?

To prevent the morbidity related to OSA/poor sleep which includes:

  • Impaired growth and development
  • Inattention/ hyperactivity
  • Learning issues
  • Metabolic effects (Diabetes)
  • Behavioural and mental health issues
  • Effects on the heart (high blood pressure)
  • Impact on the sleep/quality of life of the parents/guardians.

How is OSA diagnosed?

Consultation with a Paediatric Sleep Physician who will assess the risk for OSA from a detailed history/video records during sleep and clinical examination.

Overnight sleep study (Polysomnography) is the gold standard in diagnosing OSA and other sleep-related disorders.

What are the treatments available for OSA?

Treatment is based on the cause of obstruction and severity of OSA.

Options include:

  • Adenotonsillectomy
  • CPAP
  • Medications
  • Orthodontic treatment
  • Weight loss programs

What are the other sleep disorders in children?

  • Sleep onset disorder
  • Sleep maintenance disorder
  • Circadian rhythm disorders
  • Hypersomnia/Narcolepsy
  • Parasomnias (sleep walking, night terrors, nightmares, teeth grinding)
  • Sleep-related movement disorders

What are the conditions associated with a high incidence of sleep issues in children?

Approximately 70-75% of children with Autism Spectrum Disorder and ADHD have issues related to sleep onset/sleep settling and sleep maintenance issues.

Routine screening/evaluation and management of sleep disturbances may have long term positive impact on the well-being of these children as well as their parents/guardians.