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PEDIATRIC SLEEP APNEA

Sleep apnea is a disorder in which a child's breathing is obstructed and interrupted for periods of 5 to 10 seconds or more while he or she is asleep. These interruptions may occur hundreds of times a night, causing your child to gasp for air and disrupting sleep. The condition occurs in an estimated 1-3 percent of children. Children between the ages of two to six years old are most commonly affected, though it can be seen in infants and adolescents.

When a child's breathing is obstructed during sleep, this can affect the body in many ways. For instance, the heart rate slows, the nervous system is stimulated, blood pressure rises, the brain is aroused and sleep is disrupted. Repeated interruptions to sleep and sleep apnea can cause your child to be sleep deprived, cranky and ill behaved.

The leading cause of sleep apnea in children is enlarged tonsils and adenoids. However, some children with enlarged tonsils will not have any symptoms, whereas others with small tonsils will have severe sleep apnea. Children with other disorders, such as craniofacial anomalies, cerebral palsy, muscular dystrophy and Down syndrome are at an increased risk for sleep apnea.

To learn more about the diagnosis and treatment of sleep disorders in children, please feel free to listen to an audio program featuring Kristina W. Rosbe, MD, the Director of Pediatric Otolaryngology at UCSF, here.

At UCSF Medical Center, our pediatric ear, nose and throat specialists are experts in the diagnosis and surgical treatmentof sleep apnea in children. Tonsillectomy and adenoidectomy achieves a 90 percent success rate for childhood sleep apnea. Our pediatric ear, nose and throat specialists may also work with pediatric sleep specialists in diagnosing your child's condition and coordinating the best possible care.

To Visit Us

Our pediatric ear, nose and throat specialists are available to meet with you and your child for surgical consultation. If an operation is recommended, they will explain the procedure in detail. They also will discuss whether hospitalization is necessary after the operation and the risks and benefits of the operation.

Pediatric ear, nose and throat specialists are located in the Otolaryngology Head and Neck Surgery clinic at:

Otolaryngology-Head and Neck Surgery
400 Parnassus Avenue, 7th Floor
San Francisco, CA 94143-0342

Phone: (415) 353-2757
Fax: (415) 353-2603

Our Experts

Kristina W. Rosbe, M.D., Director of Pediatric Otolaryngology.

Anna Meyer, M.D.

Dennis Nielson, M.D., Ph.D., Director of the Pediatric Sleep Lab

Signs and Symptoms

Snoring is the hallmark symptom of sleep apnea. Approximately 10 percent of children are reported to snore and ten percent of these children suffer from sleep apnea.

In most cases, when a child with sleep apnea is awake, they breathe normally. However, during sleep, he or she will snore loudly, regardless of their sleeping position. The snoring also is interrupted by complete obstruction of breathing that causes the child to make gasping and snorting sounds, which may be alarming to parents. Also, the child may adapt strange sleeping positions.

Sleep apnea may cause a number of other problems, including:

Sleep Deprivation -- If your child is repeatedly not getting a good night sleep, he or she may become moody, inattentive and disruptive at home and school. This may affect their academic performance, participation in extracurricular activities and energy level and concentration.

Abnormal Urine Production -- Sleep apnea also causes increased nighttime urine production, which may lead to bedwetting.

Growth -- Growth hormone is secreted at night and those with sleep apnea may suffer interruptions in hormone secretion, resulting in slow growth or development.

Attention Deficit Disorder (ADD) or Attention Deficit Hyperactivity Disorder (ADHD) -- Research has shown that sleep apnea is a contributing factor to symptoms of attention deficit disorders.

Diagnosis

If you suspect that your child suffers from sleep apnea, it is recommended that you visit a pediatric ear, nose and throat specialist for an evaluation. Before visiting your doctor, it also is helpful if you observe your child while sleeping, noting any snoring, obstruction to their breathing, gasping, snorting and thrashing in bed and unexplained bedwetting. Video or audiotapes of your child sleeping can be helpful for the ear, nose, and throat specialist. During your first visit, your doctor will conduct a thorough medical examination of your child, noting any physical signs of sleep apnea, such as enlarged tonsils, which is the leading cause of the disorder. He/she will also ask about any other symptoms related to sleep apnea that your child might be experiencing such as snoring, disrupted sleep, mood changes, misbehavior and poor academic performance.

Your doctor may recommend a sleep study (polysomnogram) for your child. This test is performed in our pediatric sleep laboratory. A polysomnogram is a test of sleep cycles and stages through the use of continuous recordings of brain waves (EEG), electrical activity of muscles, eye movement (electrooculogram), breathing rate, blood pressure, blood oxygen saturation, and heart rhythm and direct observation of the person during sleep.

Treatment

Treatment depends on the severity of your child's symptoms and other factors, such as age. Tonsillectomy and adenoidectomy, a procedure in which the tonsils and adenoids are surgically removed, is the most effective treatment for sleep apnea in children. This procedure will be recommended if your child has significant symptoms and his or her tonsils and adenoids are enlarged -- the leading cause of sleep apnea. Tonsillectomy and adenoidectomy achieves a 90 percent success rate for childhood sleep apnea. Of the nearly 400,000 tonsillectomies performed in the U.S. each year, 75 percent are performed to treat sleep disordered breathing. Our pediatric ear, nose and throat specialists perform hundreds of successful tonsillectomies each year. Here at UCSF, we have new technology available to remove tonsils with less post-operative pain and a faster recovery to normal diet and activities for your child.