Apnea in children, sleep-disordered breathing problems

Obstructive Sleep Apnea Syndrome (OSAS) is a very common problem in children that until recent years has been little recognized. Some 12% of the child population snores and, of these, 2% have obstructive sleep apnea. It has been proven that OSAS produces important complications in children who suffer from it, which can be avoided with appropriate treatment, as recommended by the expert otolaryngologists Dr. Prof. Antonio Abrante and Dr. Jesús López, Co-Directors of the Otorhinolaryngology Service of the Quiron Sagrado Corazón Hospital in Seville and members of Top Doctors.

The most frequent cause is enlarged tonsils and adenoids (“vegetations”), constituting more than 95% of cases. It is followed at a great distance by congenital craniofacial malformations (30% of children with Down syndrome have OSAS), neurological and neuromuscular diseases, and obesity.

It is a REM sleep phase disease in which there is a marked reduction of activity in the muscles that keep the airway patent.

The main symptom is snoring; its absence virtually rules out the existence of OSAS. The nocturnal symptoms observed by parents are, in addition to snoring: respiratory pauses, increased respiratory effort to maintain a patent airway, abnormal postures with hyperextension of the head and profuse sweating. During the day they present morning headaches, hyperactivity, attention deficit, poor school performance, tiredness and delayed postural development. They also have symptoms related to adenotonsillar hypertrophy: mouth breathing, dry mouth/halitosis, nasal congestion, respiratory infections and speech disturbances.

In addition, children with OSAS more frequently present with prolonged episodes of tachycardia, increased hemoglobin concentrations, abnormal growth hormone secretion, elevated blood pressure, heart failure (long-term) or sudden death.

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As adenotonsillar hypertrophy is the root cause, the treatment is adenotonsillectomy, a technique that has been shown to resolve respiratory disorders in more than 90% of children from day one.