OBSTRUCTIVE SLEEP APNOEA (OSA)

• Obstructive sleep apnoea (OSA) is a condition that involves pauses while breathing, causing fragmentation of sleep. These pauses can be intermittent during different stages of sleep, causing the oxygen saturation to fall below the normal range. In normal children, the commonest cause is the adenoids and tonsils.
• In children with special needs or congenital problems can cause fall in oxygen alongwith buildup of Carbon dioxide to serious levels. This would mandate, use of other modality of treatment like non-invasive ventilation.    
• Snoring in children is quite common – about 15 to 20 per cent of children snore.
• If your child has OSA, they may have excessive tiredness/ daytime sleepiness. They may have hyperactivity, impulsiveness, learning and behavioural problems. These can also lead to future development of medical problems related to hypertension, diabetes, and other cardiac problems.

 If your child has OSA, you may notice that your child:

• has loud snoring, pauses in breathing and difficulty breathing during sleep
• chokes, gasps or snorts in their sleep
• is restless and sweaty while asleep
• sleeps in unusual positions, e.g. propped up high on pillows 
• breathes through their mouth instead of their nose at night 
• has headaches and/or is tired in the morning
• has a blocked nose, poor appetite and/or problems swallowing.Sometimes, the only problems that a child with OSA may show are difficulties with paying attention, behavioural problems and learning difficulties. 

The most common cause of OSA in childhood is enlargement of the tonsils in the back of the throat, adenoids in the back of the nose, and turbinates (small bony structures) in the breathing passage.

• obesity
• long-term allergy or hay fever
• certain medical conditions associated with weak muscles or low muscle tone, such as Down syndrome
• very small jaws or flat faces in children.

• Children who have enlarged adenoids and tonsils may need to have surgery to take them out. 
• Children who are very overweight will need to start an exercise and weight-management program. 
• Children with long-term (chronic) nasal allergy may trial a mix of different medical treatments. Your doctor will discuss these with you if necessary. 
• Children with special conditions or severe sleep apnoea may need a Continuous Positive Airways Pressure (CPAP) machine to help them breathe at night.  
• There are a few children who will need more specialised surgical procedures.