FAQs


OBSTRUCTIVE SLEEP APNOEA (OSA) IN CHILDREN

Repeated episodes of partial or complete upper airway obstruction during sleep.

  • HOW IS IT RECOGNISED?

    • Snoring is the main symptom
    • 10% of children snore and 1 out of 3 have OSA
    • Common under the age of 6 years
  • NIGHT SYMPTOMS

    • Snoring or heavy breathing
    • Laboured breathing
    • Choking or gagging 
    • Pauses in breathing
    • Excessive sweating
    • Nocturnal cough
  • DAY SYMPTOMS

    • Unrefreshed on waking
    • Irritable during the day
    • Poor concentration
  • CAUSES OF OSA

    • Large tonsils and adenoids
    • Facial dysmorphism
    • Muscle weakness
    • Obesity
  • WHAT ABOUT FAMILY HISTORY

    • If both parents snore it increases the risk of the child having OSA three fold
  • LONG TERM COMPLICATIONS

    • Poor weight gain
    • Poor concentration and behaviour problems
    • Learning difficulties
    • Increased risk of hypertension and heart failure
  • HOW IS IT DIAGNOSED?

    • Diagnostic sleep study
    • Non-invasive overnight testing of sleep and respiratory parameters
  • WHAT IS THE TREATMENT OF OSA?

    • Adenotonsillectomy (70-80% cure)
    • Continuous positive airway pressure (CPAP)
  • ANY TAKE HOME MESSAGE?

    • Snoring is not cute
    • If a child snores most nights – exclude OSA

NON RESPIRATORY SLEEP DISORDERS

  • NIGHTMARE

    • Occurs in REM sleep
    • Peak age 3-6 years
    • Able to recall dream
    • Frequent nightmares associated with underlying medical problems
  • SLEEP TERROR

    • Occurs in Non-REM sleep
    • Screaming/confusion/disoriented
    • No recall of events
    • Common age 4-12 years
  • HEAD BANGING/BODY ROCKING

    • Rhythmic movement disorder
    • Onset before 1 year of age
    • More common in boys
    • Disappears by 4 years
    • If persistent – exclude underlying medical problems

MY CHILD WON'T SLEEP

  • SLEEP ASSOCIATION DISORDER

    • Common under 12 months
    • More than 40% of infants
    • Inappropriate environmental cues
    • Requires parental input to fall asleep
  • SLEEP ONSET DISORDER

    • Common after 18 months
    • Separation anxiety
    • Limit setting disorder
    • Prolonged sleep latency
  • SLEEP MAINTENANCE DISORDER

    • Any age group
    • Difficulty in remaining asleep
    • Several wake ups during the night
    • Exclude medical problems such as sleep apnoea, developmental delay
  • DELAYED SLEEP PHASE DISORDER

    • 5-10% of adolescents
    • Difficulty falling asleep
    • Signficant difficulty waking
    • Day time sleepiness
    • Poor school performance
    • School avoidance


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