More Child Health and Safety Articles
Pediatric Sleep Apnea
Pediatric obstructive sleep apnea (OSA) affects girls and boys equally and usually begins in the first few years of life, though it may go undiagnosed until later. Here are some signs that may indicate if your child may have a sleep apnea problem
Snoring and breathing difficulty during sleep (infants, however, may not snore at all, but may still have apneas.)
Paradoxical breathing Due to their more pliant rib cages, children with OSA may show paradoxical breathing, an inward rib cage motion during inspiration.
Profuse sweating
Bedwetting
Unusual sleep positions (for example, seated or with neck hyperextended)
Excessive daytime sleepiness (typical in older children or adolescents, but not younger children)
Cognitive and behavioral problems
Developmental delay
Poor school performance
Attention deficit hyperactivity disorder (ADHD)
Aggressive behavior
Slow rate of growth in early childhood OSA can cause growth failure, especially when associated with a genetic or craniofacial disorder.
Morning headaches
Mouth breathing because pediatric OSA is often due to enlarged adenoids and tonsils, a child may also breathe through his or her mouth, have frequent upper respiratory tract infections, or have difficulty swallowing.
Risks
Large tonsils and adenoids
Obesity
Craniofacial abnormalities such as a small chin or other underdeveloped facial structures
Down's syndrome
Neuromuscular diseases
Cerebral palsy
Gastroesophageal reflux disease (may cause swelling of the upper airway leading to blockages)
Storage disorders like the mucopolysaccharidoses
Sickle cell disease
Pharyngeal flap operations to improve speech quality in children with cleft palates
Family members with sleep apnea
Diagnosis
Since diagnosis and management of pediatric OSA differs from that of adult OSA, it's important to obtain an accurate clinical and sleep laboratory assessment including a polysomnogram.
Treatment Options
Adenotonsilectomy (removal of the tonsils and adenoids)
Positive pressure breathing (also referred to as continuous positive airway pressure [CPAP]). This may be used if adenotonsilectomy doesn't help. The level of air pressure depends on each patient's needs.
Losing weight. If excessive weight contributes to a child's OSA, then losing weight may be part of their treatment plan.
Oral appliance. The appliance moves the bottom jaw and tongue forward to keep the upper airway open.
Septoplasty (turbinate reduction). Septoplasty straightens a deviated septum (bony partition between the nostrils) and turbinate reduction trims or removes one or more of the curved bones along the wall of the nasal passage.
Jaw surgery (orthognathic surgery). In this surgery, the upper jaw, lower jaw and/or chin may be moved forward.
Surgery is usually a good option for older adolescents whose jaw structure worsens blockage of the upper airway and who haven't been helped by other treatments.
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