Diagnosis and Treatment: Apnea

Apnea
Symptoms
Diagnosis
Treatments

Apnea also called obstructive sleep apnea syndrome is one of the common problem in children, and is increasing being recognized as a cause of daytime attention and behavioral problems due to sleep depravation.

Unlike adults with sleep apnea, who are often overweight and frequently wake up at night, children with apnea are more difficult to recognize and diagnosis.

Children with Down syndrome are at higher risk for apnea and should be closely watched for symptoms. Other medical conditions, including various neuromuscular and central nervous system abnormalities, craniofacial abnormalities are also often associated with apnea.

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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 on a regular or intermittent basis.

In addition to continuous loud snoring, other symptoms of obstructive sleep apnea in children include:

Failure to thrive (weight loss or poor weight gain)
Mouth breathing
Enlarged tonsils and adenoids
Problems sleeping and restless sleep
Excessive daytime sleepiness
Day-time cognitive and behavior problems, including problems paying attention, aggressive behavior and hyperactivity, which can lead to problems at school

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Diagnosis

The diagnosis of apnea in children is usually based on the characteristic symptoms and evidence of adenotonsilar (adenoid and tonsils) hypertrophy (enlargement) and mouth breathing. Children suspected of having apnea should usually be evaluated by an ENT Pediatrician for further evaluation.

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Treatments

Although younger children with apnea 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 apnea symptoms in children that also have allergies.

The main treatment for kids with apnea due to obstructive sleep apnea is surgery, with removal of the child's enlarged tonsils and adenoids (tonsillectomy and adenoidectomy).