Paediatrics Q5

Obstructive Sleep Apnoea in Children

Introduction

Obstructive sleep apnoea (OSA) in children is a sleep disorder characterized by recurrent episodes of upper airway obstruction that occur during sleep. This leads to disrupted sleep and can have various negative impacts on a child’s health and daily functioning.

Clinical Presentation

1. Snoring

2. Gasping or choking while asleep

3. Night sweats

4. Breathing through an open mouth

5. Excessive daytime sleepiness

6. Difficulty awakening in the morning.

Risk Factors

. Obesity

. Craniofacial abnormalities

. Adenotonsillar hypertrophy

. Gastro-oesophageal reflux

. Family history of sleep apnoea

Investigations

i. Sleep study (polysomnography) to confirm diagnosis.

ii. ENT evaluation to assess adenotonsillar hypertrophy.

iii. Imaging studies, such as X-rays or MRI, for craniofacial abnormalities

iv. Gastroesophageal reflux evaluation, if applicable

Management

Treat underlying cause:

1st Line

Adenotonsillectomy: Surgical removal of the adenoids and tonsils to open the airway and relieve obstruction.

Consider

1. Continuous Positive Airway Pressure (CPAP): A machine that uses mild air pressure to keep airways open, used especially in cases where adenotonsillectomy is not feasible or effective.

2. Treatment of precipitants or related disorders: This may include management of gastro-oesophageal reflux or weight loss strategies for obese children.

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