Sleeping soundly


Many parents are comforted and amused by the snoring of their child. However, the noise that your little one makes while “sawing logs” can be a sign of a condition called obstructive sleep apnea.  Obstructive sleep apnea is commonly associated with overweight adults, but many parents don’t know that children can experience obstructive sleep apnea, too.
Obstructive sleep apnea is a condition in which normal upper airway breathing is restricted or blocked during sleep.  Signs of obstructive sleep apnea in children include snoring, restless sleeping, bedwetting, night terrors and, of course, observation of brief periods of apnea.  Symptoms of obstructive sleep apnea in children include irritability, hyperactivity, mouth breathing, headaches, daytime sleepiness and learning difficulties.
If you suspect that your child may have obstructive sleep apnea, you may want to start with an evaluation by your primary care provider or an ENT specialist.  A polysomnogram (sleep study) is often performed to confirm obstructive sleep apnea.  A complete examination of the anatomy of the nose and throat is important to identify structures that can cause narrowing or obstruction of the upper airway, which can lead to obstructive sleep apnea.  An X-ray or CT scan can also be used to examine the internal facial and neck anatomy. While this may sound like a scary experience for children, some places, including the Toledo Clinic ENT, offer friendly solutions like an in-office sit down CT scanner to examine internal structures of the head and neck.
The treatment for OSA varies depending on the cause.  In many cases, enlarged adenoids or tonsils or swelling in the nose from allergies can be to blame. Allergy testing and treatment to identify and address environmental factors is important.  Medical treatment can involve antihistamines, decongestants or steroid nasal sprays to reduce nasal swelling from allergies.
Weight loss through exercise and smart dietary choices is beneficial.  In cases where medications or lifestyle modification is not enough, sometimes upper airway surgery is indicated.  Outpatient procedures include adenotonsillectomy, which alleviates the obstruction of the nose and throat, and turbinoplasty, which reduces intranasal tissue swelling. These procedures can often cure or significantly improve pediatric obstructive sleep apnea.
Obstructive sleep apnea is a serious condition, but one that can be successfully treated in children.  So next time you watch your little one sleep, take note of their breathing habits. If you think your child may have obstructive sleep apnea, a trip to your primary care provider or an ENT specialist can ease your mind and help your child sleep better.

Melissa Harris-Martorana, MD is an internal medicine physician and member of ProMedica. Physician Group.