A new set of guidelines was released by the American Academy of Pediatrics (AAP) that can help parents and pediatricians to understand and diagnose why children snore when sleeping.
The pediatric sleep experts studied kids’ with a condition known as uncomplicated obstructive sleep apnea (UOSA), which happens when their breathing is interrupted while sleeping and is related to enlarged tonsils or obesity. The AAP says this condition affects 1.2 to 5.7 % of American kids. After reviewing evidence from 350 study articles from 1999 to 2010, they have created the following recommendations:
- Screening: All children and adolescents should be screened for snoring during their routine health visits with their pediatrician.
- Sleep testing: Any kids that have symptoms of obstructive sleep apnea, such as habitual snoring, disturbed sleep from intermittent pauses, snorts or gasps, or daytime behavioral problems, should be referred for a sleep study.
- Adenotonsillectomy: Any child with obstructive sleep apnea and enlarged tonsils should be referred to a surgeon for consideration of surgery to remove their tonsils.
- High risk: A child having tonsils removed is considered “high-risk” if he or she is under the age of 3, has severe sleep apnea on sleep testing; is obese or currently has an infection. After surgery these children should be closely monitored while in the hospital for any complications.
- Re-evaluation: After having surgery, these kids that snore, should be reassessed to see if their sleep apnea has improved or if they will need any further treatments.
- CPAP Machine: If their symptoms do not improve after surgery or if for some reason, a child is unable to have surgery, they should be considered for a CPAP (continuous positive airway pressure) machine, which is a breathing mask, often worn at night, that keeps airways open.
- Weight loss: It is recommended for any overweight or obese patient to lose weight in addition to any other treatments.
- Intranasal steroids: Nasal sprays are recommended for patients with mild sleep apnea symptoms, whether in lieu of or after tonsil surgery.
The latest set of guidelines for pediatric sleep apnea was released back in 2002. The changes reflected in these new guidelines were made in light of research over the past 10 years that has suggested that delayed diagnosis of childhood sleep apnea “can result in severe complications if left untreated,” according to the American Academy of Pediatrics report. Examples include cognitive deficits, behavior problems, hypertension and heart problems, failure to thrive and inflammation throughout the body.
The AAP hopes that with these new guidelines, that more cases of childhood sleep apnea will be diagnosed sooner and children will receive the proper treatments earlier to prevent these dangerous long-term effects.
Dr. Vikas Jain, a sleep specialist at Integris Health in Oklahoma City says, “These new guidelines are extremely important.” He also says, “Pediatric sleep apnea is a rising problem among American children and leads to serious consequences, the sooner we can diagnose a child with this condition, the sooner we can get these kids started on the right treatments to improve their quality of life and their overall health.”