CPAP

Snoring and Sleep apnea is a condition of interrupted breathing cause by a narrowing in the throat or upper airway. These breathing pauses typically last between 10 to 60 seconds and can occur up to hundreds of times a night.

This narrowing can be due to enlarged tonsils and adenoids, obesity, or other medical problems. This condition occurs in both adults and children, but is most prevalent in obese patients.

This chronic sleep deprivation in kids results in daytime sleepiness, slow reflexes, poor concentration, and poor performance in classroom.

Causes of Snoring in Children

and Adenotonsillar hypertrophy – the commonest cause

and Obesity – increases the risk of OSA nearly five times.

and Neuromuscular diseases-presence of craniofacial abnormalities.

Symptoms

and Snoring – usually parents seek attention; many will just get better as they grow older.

and Mouth breathing and dental anomalies-Adenoid Face

and Choking and gasping for breath at night

and Daytime somnolence and tiredness are prominent

and Not doing well at school due to poor concentration.

and Failure to thrive.

and Behavioral problems.

and Enuresis – thought to be due to lack of awareness overnight.[2]

Types of sleep apnea

and Obstructive sleep apnea is the most common type of sleep apnea. It occurs when the soft tissue in the back of your throat relaxes during sleep and blocks the airway, often causing you to snore loudly.

and Central sleep apnea is a much less common type of sleep apnea that involves the central nervous system, occurring when the brain fails to signal the muscles that control breathing. People with central sleep apnea seldom snore.

and Mixed sleep apnea is a combination of obstructive sleep apnea and central sleep apnea.

Other signs and symptoms of sleep apnea

and Morning headaches

and Memory or learning problems and not being able to concentrate

and Feeling irritable, depressed, or having mood swings or personality changes

and Dry mouth or sore throat when you wake up

Investigations

The gold standard is probably polysomnography, commonly called sleep studies.

Other investigations that may be needed

and Lateral neck radiography, e.g. CT/MRI scan.

and Blood Tests to rule out Hypothyroidism Diabetes etc

and X-ray Chest and ECG

Treatment

Medical

and Continuous positive airways pressure (CPAP) is rarely used for children. It may be considered if adenotonsillectomy is not possible or has failed.

and Weight loss programme in obese children.

and There is no role for antibiotics (unless tonsillitis is present) or for steroids.

Surgical

Adenotonsillectomy for adenotonsillar hypertrophy. This is curative in the majority of patients. The surgeon may remove tonsils, adenoids, or excess tissue at the back of the throat or inside the nose. Or the surgeon may reconstruct the jaw to enlarge the upper airway. Children who had these surgeries have experienced improvements in behavior, quality of life, and other symptoms.

Tracheostomy – very rarely indicated and only as an exceptional last resort.

CPAP for sleep apnea?

Continuous Positive Airflow Pressure (CPAP) is the most common treatment for moderate to severe obstructive sleep apnea in adults but not usually recommended unless other treatment fails. A CPAP machine prevents sleep apnea by blowing air into a mask that covers the nose and mouth. The stream of air keeps the airways open.

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