Paediatric obstructive sleep apnoea (OSA) is a common sleep disorder where a child’s breathing is repeatedly blocked during sleep, most often caused by enlarged tonsils and adenoids. While the condition can be serious, it is highly treatable with specialist care.
- Key Symptoms: The most common signs are loud, habitual snoring, noticeable pauses in breathing or gasping for air during sleep, and daytime behavioural issues like hyperactivity or poor concentration.
- Potential Impacts: Untreated OSA can affect a child’s growth, cognitive development, and behaviour, and may strain their cardiovascular system over time.
- Effective Treatment: For moderate to severe cases, the most common and effective treatment is an adenotonsillectomy, a surgical procedure to remove the tonsils and adenoids.
What is Paediatric Obstructive Sleep Apnoea
Paediatric obstructive sleep apnoea is a sleep disorder where a child’s airway repeatedly becomes partially or completely blocked during sleep. This blockage reduces or stops airflow. It causes their oxygen levels to dip and disrupts their sleep.
Unlike in adults, where OSA is often linked to lifestyle factors, sleep apnoea in children is most commonly caused by physical obstructions like large tonsils and adenoids. It is a significant condition that affects an estimated 1-5% of Australian children. It requires proper diagnosis and management from a specialist.
Why is My Child Snoring? Recognising the Symptoms
Knowing the difference between simple, occasional snoring and the kind that points to a problem can be a challenge. Children with OSA often show a distinct pattern of night-time and daytime symptoms.
Observable symptoms you might notice at night:
- Loud, habitual snoring that happens most nights.
- Pauses in breathing, followed by gasping, snorting, or choking sounds.
- Restless sleep, with lots of tossing and turning.
- Sleeping in unusual positions, like with their head propped up or neck extended.
Daytime symptoms you might not expect:
- Difficulty waking up in the morning or complaining of headaches.
- Feeling tired or falling asleep during the day.
- Hyperactivity, inattention, or behavioural issues that can be mistaken for ADHD.
- Poor performance or difficulty concentrating at school.
Physical signs can include:
- Breathing through their mouth consistently, both day and night.
- Bedwetting, especially if they were previously dry at night.
- Slow growth or a failure to thrive.
If you are worried about your child’s snoring, trust your instincts. It is always worth investigating with your GP or a specialist.
The Consequences of Untreated Sleep Apnoea in Children
Sleep is a critical time for a child’s growth and development. When sleep is consistently disrupted by OSA, the consequences can be significant.
- Growth and Development: Untreated OSA can disrupt the release of growth hormone, which is primarily secreted during deep sleep. This can lead to slower growth and what is known as ‘failure to thrive’.
- Cognitive and Academic Impact: Research shows that persistent sleep-disordered breathing can have a real impact on brain development.
- Behavioural Issues: The link between poor sleep and behaviour is strong. Children with OSA are often misdiagnosed with ADHD due to symptoms like hyperactivity, irritability, and emotional dysregulation.
- Long-Term Health: Over time, the strain of OSA can put pressure on a child’s cardiovascular system.
What Causes Obstructive Sleep Apnoea in Children
In the vast majority of cases, paediatric OSA is an anatomical issue. A child’s airway is small. When certain tissues are enlarged, they can easily block it during sleep.
The most common causes are:
- Enlarged Adenoids and Tonsils: These are the primary culprits. Adenoids are glands located behind the nose, and tonsils are at the back of the throat. When they are enlarged, they can physically obstruct the airway.
- Other Contributing Factors: While less common, factors like childhood obesity, allergies that cause nasal swelling (allergic rhinitis), or certain craniofacial abnormalities can also contribute to the condition.
The condition is most common in preschool-aged children (3-6 years). This is when the adenoids and tonsils are at their largest relative to the size of the airway.
How is Paediatric Sleep Apnoea Diagnosed
The diagnostic journey starts with a conversation. Your GP will listen to your concerns and may refer you to an ENT specialist like Dr Thomas Nguyen for a thorough evaluation.
An ENT specialist will:
- Take a Detailed History: They will ask about your child’s sleep patterns, snoring, and any daytime symptoms you have noticed.
- Perform a Physical Examination: This involves looking at the size of the tonsils and assessing the nasal passages. Sometimes, a small, flexible camera called a nasal endoscope is used to get a clear view of the adenoids.
- Recommend a Sleep Study (Polysomnography): This is the gold standard for diagnosis. Your child will stay overnight in a specialised clinic where their breathing, oxygen levels, heart rate, and brain activity are monitored while they sleep. This test confirms the diagnosis and measures the severity of the OSA.
Treatment Options From Watchful Waiting to Surgery
Once a diagnosis is confirmed, Dr Nguyen will discuss the best course of action. Treatment depends on the severity of the OSA, your child’s age, and the underlying cause.
Non-Surgical Approaches
For very mild cases, or in children who may be likely to outgrow the issue, non-surgical options might be considered first.
- Watchful Waiting: If symptoms are mild and not impacting development, a period of observation may be recommended.
- Medical Management: If allergies are contributing to the problem, nasal steroid sprays or other allergy treatments can sometimes help reduce swelling in the airways.
- Weight Management: For children where obesity is a significant factor, a weight management plan is an important part of treatment.
Surgical Interventions
For moderate to severe OSA, or when symptoms are affecting a child’s quality of life, surgery is often the most effective solution.
- Adenotonsillectomy: This is the surgical removal of the adenoids and tonsils. It is the gold standard treatment for paediatric OSA caused by enlarged tissues.
- Turbinate Reduction: If swollen nasal tissues (turbinates) are causing significant nasal obstruction, they may be reduced at the same time.
Why Choose Dr Thomas Nguyen for Your Child’s ENT Care
Making decisions about your child’s health requires trust. Dr Nguyen is committed to providing expert, family-centred care that puts your child’s wellbeing and your peace of mind first.
- Dual Specialisation: Dr Nguyen has extensive experience in both paediatric and adult ENT conditions, with advanced training in procedures like adenotonsillectomy.
- Multi-Location Convenience: With practices in Liverpool, Gregory Hills, and Forster, his team offers accessible care with reduced wait times for families across South Western Sydney and the Mid North Coast NSW.
- Family-Centred Philosophy: We understand parental anxiety. Dr Nguyen takes the time to explain everything clearly, without medical jargon, and ensures you feel confident and informed at every step.
- Comprehensive Diagnostics: With on-site nasal endoscopy and coordinated referrals for sleep studies, we provide a seamless and thorough diagnostic process.
- Transparent Communication: You will receive honest, realistic expectations about outcomes and accessible support throughout your child’s recovery.
Booking a Consultation Today
If you are concerned about your child’s snoring, breathing, or sleep quality, a specialist evaluation is the first step toward getting the right answers and treatment.
Contact Dr Nguyen’s practice today to schedule a consultation. Please bring your GP referral, Medicare card, private health insurance details, and any previous sleep study results to your appointment.
