Obstructive sleep apnoea in children
Obstructive sleep apnoea (OSA) is a condition in which a person periodically stops breathing for a very short time during sleep, disrupting normal breathing and sleep patterns.
It is often associated with snoring, but while snoring is quite common — affecting about 15 per cent of children — only about one to 4 per cent of children are thought to have OSA.
Causes of obstructive sleep apnoea in children
During sleep, the muscles in the walls of the throat relax, and the upper airway narrows. In OSA the airway becomes partially or totally blocked off momentarily during sleep.
OSA occurs in children of all ages, but is most common between the ages of 2 and 6 years. This is the time when the tonsils and adenoids are at their largest compared to the rest of the airway.
Large tonsils and adenoids are the most common cause of OSA in children, but not all upper airway obstruction during sleep is due to this.
Factors associated with OSA in childhood include long-term allergic rhinitis (hay fever), obesity, certain medical conditions such as Down syndrome, and other anatomical factors, such as a very small jaw or flat face.
Symptoms
Most parents of children with OSA will usually notice that their children snore, have pauses in their breathing and may be restless during sleep.
Other symptoms of OSA may include breathing through the mouth rather than the nose at night, sleeping in positions with the neck extended, excessive sleepiness during the day, behavioural problems and learning difficulties.
How is obstructive sleep apnoea diagnosed?
The doctor will start by taking a history about your child's sleep and then perform a physical examination, including looking for signs of enlargement of the adenoids and tonsils.
The best way of diagnosing and assessing the severity of OSA is a sleep study. This involves an overnight sleep at a specialised paediatric sleep unit, so that the doctors can observe your child's breathing, oxygen levels and the activity of the brain, eyes and muscles.
Treatment for obstructive sleep apnoea
The treatment will vary depending on the cause and severity of the OSA. Not all children with OSA will need to have their tonsils and adenoids removed.
Children with long-term allergic rhinitis and mild OSA may benefit from a trial of medication.
Surgical removal of the tonsils and adenoids (adenotonsillectomy) will solve the problem in about 70 to 90 per cent of cases. If the OSA is quite severe, the child may be given a CPAP (continuous positive airways pressure) machine to help them breathe at night.
Your doctor will advise you as to the most appropriate treatment in your child's case.
Last Reviewed: 10 October 2012
- 1. Paediatric sleep-disordered breathing (revised October 2009). In: eTG complete. Melbourne: Therapeutic Guidelines Limited; 2012 Jul. http://online.tg.org.au/complete/ (accessed Oct 2012).
2. Royal Children’s Hospital Melbourne – Kids Health Info. Childhood obstructive sleep apnoea – OSA (updated November 2010). http://www.rch.org.au/kidsinfo/fact_sheets/Childhood_obstructive_sleep_apnoea_OSA/ (accessed Oct 2012).
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