Snoring / Sleep Apnea

For children, instead of snoring, many have open mouth breathing as their nose passages are tiny. The child is restless, tossing and turning in sleep with mouth open and often bed wetting. Snoring needs to be evaluated to exclude central or obstructive sleep apnea (OSA) and upper airway resistance syndrome, where there is blood oxygen deprivation and open mouth breathing leading to disturbed sleep, hyperactivity or tiredness, poor focus and concentration in school, dental caries and lack of lower jaw growth. Long term, oxygen deprivation may reduce growth, cause underweight or overweight, heart strain, high blood pressure and diabetes.

Investigations offered:

• Full evaluation of weight, nose throat neck and flexible nasolaryngoendoscopy in clinic to determine the sites of obstruction
• Sleep study (home or hospital based) to determine the severity and pattern of obstructive/ central sleep apnea in some cases

Treatment offered:

• Non-surgical treatment for obesity and nose allergy
• Continuous positive airway pressure mask (CPAP) is not usual as first line treatment for children
• First line surgery addresses the adenoid, tonsil and inferior turbinate sites of blockage
• Surgery tailored to the soft palate, base of tongue and larynx sites of blockage
• Surgery for tongue base and mandibular advancement surgery in some syndromic cases