What Is the Best Treatment for Obstructive Sleep Apnea In Children?

Obstructive sleep apnea in children is a common sleep disorder characterized by repeated pauses in breathing during sleep. It is caused when the upper airways get narrower due to enlarged tonsils or adenoids or allergies. There are other reasons, such as structural abnormalities in the skull or face, congenital diseases, etc. It affects children age 2-8 years. It represents symptoms like snoring, nocturnal bed wetting, breathing problems, restless sleep, coughing or choking, mouth breathing, etc. It is diagnosed after a complete evaluation of the case through medical and personal history, polysomnogram, and other tests. It is often treated by surgical removal of the blockage in the upper airways.

What Is the Best Treatment for Obstructive Sleep Apnea In Children?

The best treatment recommended for children with obstructive sleep apnea is the surgery that involves the removal of his enlarged tonsils and adenoids. This procedure is known as a tonsillectomy and adenoidectomy or T&A. At present, most T & A’s in the United States are conducted to treat sleep-disordered breathing and obstructive sleep apnea.(2)

In most of the cases, surgery (T & A) have an excellent outcome with complete resolution of sleep apnea in children. If this surgery does not exceed, further surgical procedures may be required. Continuous positive airway pressure (CPAP) or orthodontic methods such as rapid maxillary expansion may be recommended for new treatment.(2)

The treatment procedures for obstructive sleep apnea include-

  • Medications- the symptoms of mild obstructive sleep apnea can be relieved by topical nasal steroids, such as fluticasone (Dymista, Flonase Allergy Relief, Chance,) and budesonide (Rhinocort). Montelukast (Singulair) is used to relieve symptoms when prescribed alone or with nasal steroids for children with allergies.(3)
  • Removal Of The Tonsils And Adenoids- pediatrician, may discuss the condition of the child having obstructive sleep apnea with a pediatric ear, nose and throat specialist related to the removal of the tonsils and adenoids. An adenotonsillectomy (ad-uh-no-tonsil-EK-to-me) procedure is selected to improve obstructive sleep apnea by removing the blockage and opening the airway. In some cases, other forms of upper airway surgery might be recommended according to the condition of the child.(3)
  • Oral Appliances- Oral appliances, like dental devices or mouthpieces, can also be used to move the bottom jaw and tongue forward that can keep the upper respiratory tract open.(3)
  • Positive Airway Pressure Therapy- This therapy is recommended when other treatments and surgery fail to relieve the child completely. Continuous positive airway pressure (CPAP) and bi-level positive airway pressure (BPAP) is marked by small machines which gently blow air through a tube and mask attached to the child’s nose, or nose and mouth. The machine sends air pressure into the back of the throat of the child to keep the airways open during sleep. In most cases of pediatric obstructive sleep apnea, positive airway pressure therapy is selected. Proper fitting of the mask and refitting is ensured so that with the growth of the child, the mask over the face of a child can be easily adjusted.(3)

Pediatric obstructive sleep apnea (OSA) is a sleep disorder of children characterized by disturbance in breathing due to incomplete or complete blockage repeatedly happening during sleep. It occurs when the upper airway during sleep is blocked or becomes narrower during sleep. It is the leading cause of daytime attention and behavior problems in children.(1)

This disorder is represented by the symptoms like frequent breaks in the breathing while sleep, restless sleep, frequent waking up in the night, nightmares, bed-wetting, snoring, coughing, choking, excessive daytime sleepiness, and attention or behavioral problems.(1)

Conclusion

Obstructive sleep apnea in children is usually caused due to shrinkage and blockage of the upper respiratory tract by enlarged tonsils and adenoids. The best way to treat this disorder is the surgical removal of these tonsils and adenoids. It can provide a permanent resolution of sleep apnea in children.

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