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child with sleep apnea?


sbgrace
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We got a letter today that my son has moderate sleep apnea according to the sleep study we did last week. The letter just said he should be referred to ENT and a sleep disorders clinic.

 

I'm assuming they'll want to do surgery.

 

Does anyone have experience in treating sleep apnea in kids?

 

I have apnea myself. First line treatment for me was cpap. I don't gather it's the same for kids, but adenotonsillectormy is first line. 

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It depends on what is causing the apnea.  If the apnea is enlarged adnoids/tonsils, then they would have to come out.  If it is due to the brain telling the body to stop breathing, then there is medication for that.  Adults will have the airway actually collapse - that is what is pushed open by a CPAP.  Some children (and adults) have apnea due to weight issues - for them losing weight might solve the problem. 

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I wish i could help but at this point I'll only be following this thread as my dd10 had an appt. with her ENT just this morning. Her tonsils and adenoids are normal in size so a sleep study has been ordered....sigh. :-)

D

 

Actually, this is helpful. So an ENT can tell by looking if the tonsils/adenoids are a factor or not? I'm just hoping it's not a routine thing with this diagnosis.

 

I have apnea, so does my mother, my sister, aunt....my son takes after this side of the family. So I'm guessing his issues are more facial/jaw structure than tonsils. I feel reassured to think an ENT can tell whether surgery might help or not.

 

To reassure--the sleep studies are pretty easy. The worst part is that people typically don't sleep well in the environment (wires everywhere, not your bed, etc.) and then they wake you up and boot you out in the very early morning! So it's not a restful night.

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With kids the first line of defence is to do surgery.  With anyone it is not 100%  I have dont study with kids that their apnea was "cured" after and some that it became less. 

If they have apnea now they typically dont really out grow it as some believe.  If you lose the T&A you are less likely to get apnea later in life depending if on why the airway is closing.

Get the surgery if they have apnea or other health problems.  Please please do a follow up in 6mos to a year and see what is going on some kids are fixed some still have a small air way and will still need CPAP.  Make sure there is no deviated septum and the airway is large enough (some are born with a small air way) also talk with the dentist about how far back the jaw falls in to the airway when laying back relaxed (that blocks lots of air ways)

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Actually, this is helpful. So an ENT can tell by looking if the tonsils/adenoids are a factor or not? I'm just hoping it's not a routine thing with this diagnosis.

 

I have apnea, so does my mother, my sister, aunt....my son takes after this side of the family. So I'm guessing his issues is more facial/jaw structure than tonsils. I feel reassured to think an ENT can tell whether surgery might help or not.

 

To reassure--the sleep studies are pretty easy. The worst part is that people typically don't sleep well in the environment (wires everywhere, not your bed, etc.) and then they weak you up and boot you out in the very early morning! So it's not a restful night.

My son's tonsils and adenoids were not significantly large, and if the sleep study hadn't reported OSA they probably wouldn't have been removed. However, when the ENT went in for surgery, she found that they were both much larger than expected. She explained it like belly buttons, some have an innie and some have an outie.  

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With kids the first line of defence is to do surgery.  With anyone it is not 100%  I have dont study with kids that their apnea was "cured" after and some that it became less. 

If they have apnea now they typically dont really out grow it as some believe.  If you lose the T&A you are less likely to get apnea later in life depending if on why the airway is closing.

Get the surgery if they have apnea or other health problems.  Please please do a follow up in 6mos to a year and see what is going on some kids are fixed some still have a small air way and will still need CPAP.  Make sure there is no deviated septum and the airway is large enough (some are born with a small air way) also talk with the dentist about how far back the jaw falls in to the airway when laying back relaxed (that blocks lots of air ways)

This is good advice.

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My ds had his first sleep study in 9/12. He had a tonsil and adenoidectomy 12/12. The doctor also removed part of his soft palate. ds had a second sleep study in 2/13. His apnea was greatly improved , but still a significant problem. Before the surgery ds frequently did not sleep, so the improvement was immediately obvious. Since it was determined the apnea was still a problem, ds was tested with a Bipap (looks same as cpap, air flow is a little different). His third sleep study was 6/13. He is doing a lot better. 

 

 

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DD7 had her tonsils and adenoids out to treat mild apnea but it did almost nothing to help.  Her follow up study came back with an insignificant decrease in numbers.   She has an unlabeled sleep disorder but it is becoming clear that it is not related to her apnea.  The sleep specialist recognizes that there is clearly something wrong, but it just doesn't have a name or treatment .  :0( 

 

 

DD7 sleeps 8-10 hours and then after being awake for about 2-3 hours, takes a 2 hour nap.  It is often in the middle of a full classroom of noisy kids on a lightly carpeted, concrete floor.  She just lays down, falls asleep and doesn't wake up for an hour or two. It isn't cataplexy (or her very mild apnea) and since her her nighttime sleep is good quality they do not feel like she is sleep deprived.  She is just needs a 2 hour nap at 9 in the morning, after a full night of sleep.  ;0? 

 

 

 

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What is AHI and the arousal index and lm index with last study?  Are there any afnars/rera?

Is this a person that needs to sleep longer than others?  Some people need 10 hrs vs 8 vs 6

What is your dc normal?  Is the lab willing to let your child go to bed at normal and wake on their own? (some will some wont)  What are is dc doing different at home vs lab?

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A sleep study showed that DS2 (3.5) had OSA.  He just had his tonsils and adenoids out about 3 weeks ago, we'll be repeating the sleep study in another couple months to see if he has improved.  I have noticed his snoring has stopped and he's not as restless at night now, occasionally he'll even stay in his bed for most of the night.  The recovery was miserable for him but now that we're through with it I'm glad we did it.

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Thank you OP for the reassurance about the upcoming sleep study. I'm praying they are able to get something (anything!) from it. :-).

It was her allergist who referred her to the ENT. Despite keeping up on her medications for her allergies and asthma, she is still breathing through her mouth at night, continues to wake frequently through the night, has difficulty focusing, is always tired during the day, etc. The ENT took X-rays of her sinuses and fund that both her tonsils and adenoids were not enlarged at all. It was very clear from the X-rays that her sinuses and nasal passages were clear- no obstruction whatsoever from adenoids/tonsils. Given these results, she then referred dd10 for a sleep study.

I hope this makes sense as this is all new to me and I'm still trying to process it all. ;-)

D

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