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by Vincent
Iannelli, MD for About.com
Pediatric Basics
Obstructive sleep apnea syndrome (OSAS) is a common problem in
children, and is increasing being recognized as a cause of daytime
attentional and behavioral problems.
Unlike adults with sleep apnea, who are often overweight and frequently
wake up at night, children with OSA are more difficult to recognize and
diagnosis.
Symptoms
Although snoring is a common symptom in children with obstructive
sleep apnea, it is important to remember that between 10-20 percent of
normal children snore (primary snoring) on a regular or intermittent
basis.
In addition to continuous loud snoring, other symptoms of obstructive
sleep apnea in children include:
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failure to
thrive (weight loss or poor weight gain)
-
mouth
breathing
-
enlarged
tonsils and adenoids
-
problems
sleeping and restless sleep
-
excessive
daytime sleepiness
-
daytime
cognitive and behavior problems, including problems paying attention,
aggressive behavior and hyperactivity, which can lead to problems at
school
Diagnosis
The diagnosis of
OSA in children is usually based on the characteristic symptoms and
evidence of adenotonsillar hypertrophy (big tonsils and adenoids) and
mouth breathing. Children suspected of having OSA should usually be
evaluated by a Pediatric ENT specialist for further evaluation.
If necessary, further testing might include polysomnography (a pediatric
sleep study).
Treatments
Although most younger children with OSA are not overweight, if a child
is overweight, that might contribute to his symptoms. Weight loss is
therefore important for overweight children with obstructive sleep apnea.
Other underlying medical conditions, especially allergies, should also be
treated. A nasal steroid might help improve nasal obstruction and OSA
symptoms in children that also have allergies.
The main treatment for kids with OSA is surgery, with removal of the
child's enlarged tonsils and adenoids (tonsillectomy and adenoidectomy or
T&A).
What You Need To Know
As in adults, obstructive sleep apnea can cause a lot of
complications, including poor growth, headaches, high blood pressure and
other heart and lung problems.
OSA, and sleep problems in general, are increasingly being recognized as a
cause of children's daytime school and behavioral problems. If your child
is having problems at school or with his behavior and he snores loudly,
you should ask your Pediatrician about OSA.
Children with Down Syndrome are at big risk for OSA and should be closely
watched for symptoms. Other medical conditions, including various
neuromuscular and central nervous system abnormalities, craniofacial
abnormalities, like Pierre Robin sequence, Treacher Collins syndrome and
Crouzon syndrome, are also often associated with OSA.
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