PEDIATRIC OBSTRUCTIVE SLEEP APNEA (OSA)

Is your child snoring loudly at night and having trouble with behavior or learning during the day? Your child could have pediatric obstructive sleep apnea (OSA) -- a blocking of the airways that affects breathing and disrupts sleep.

What is pediatric OSA?

Pediatric obstructive sleep apnea (OSA) is a sleep disorder that causes a child's breathing to repeatedly stop and start during sleep. It affects a child night and day. It not only interrupts sleep but also affects mood, behavior and learning. Pediatric OSA can even cause heart problems and affect a child's ability to grow.

In children, OSA is often caused by larger than usual tonsils and adenoids. The tonsils are two small pads of tissue in the back of the mouth. The adenoids are two small pads of tissue in the back of the nose. Being born with certain conditions and being above a healthy weight also are risk factors for OSA.

What are the symptoms of OSA in children?

Snoring may be the most noticeable symptom of OSA in children. Most, though not all, children with OSA snore. But snoring is not enough to diagnose a child with OSA because some children who don't have OSA snore too.

Other OSA symptoms in children may include:

Pausing between breaths during sleep.
Snorting, coughing or choking during sleep.
Sleeping in unusual positions, such as with the neck stretched out -- this may be an effort to keep the airways open.
Wetting the bed after being dry at night in the past.
Sleepwalking or sleep terrors.
Breathing through the mouth during the day.
Trouble paying attention.
Falling asleep often during the day, such as at school or during short car rides.

What are the treatment options for OSA in children?

Whether and how to treat a child's OSA depend on:

How bad the symptoms are.
How it affects sleep and daytime behavior.
Age and overall health.

Treatment options may include:

Surgery. If symptoms are moderate or worse, your health care team may recommend surgery to remove the tonsils and adenoids. This helps open up a child's airways. Depending on the child's condition, other types of upper airway surgery also may help.
Watchful waiting. If a child is otherwise healthy, and OSA symptoms are mild or moderate, it can be an option to wait up to six months before considering surgery. After that time, the health care team can recheck the child's symptoms. Some children may outgrow OSA. During this waiting period, the health care team may recommend treating other related conditions, such as allergies, asthma and dry nose, if the child has any.
Positive airway pressure therapy. A small machine gently blows air through a tube. The tube attaches to a mask that's worn over the nose or over both the nose and mouth. The air pressure holds the airways open. This treatment is more commonly used in adults with OSA, but it can work well for some children.
Encourage sleeping on the side. For some children, OSA may be worse with certain sleeping positions. If this is the case, in addition to other treatments, it may help to raise the head of the bed or to encourage sleeping on one's side. Special pillows or belts -- or even a tennis ball attached to the back of a child's sleepwear -- can prevent sleeping on the back.
Medicines. Steroid nasal sprays may help some children with OSA. For kids with allergies, allergy medicines used alone or in combination with steroid nasal sprays may help.
Mouth appliance (orthodontics). A mouth device or appliance can help some children with OSA. These devices help widen the roof of the mouth, also called the palate, and open the airways. Other devices might move a child's bottom jaw and tongue forward to keep the upper airway open.

What else can ease symptoms?

Lifestyle changes also can help ease OSA symptoms in children.

Avoid airway irritants and allergy triggers. All children, especially those with OSA, should avoid exposure to tobacco smoke. It's also important to avoid exposure to indoor allergy triggers and pollutants. All of these substances can irritate the airways.
Maintain a healthy weight. If a child is above a healthy weight, losing weight may help improve breathing.

2024-05-07T12:56:30Z dg43tfdfdgfd