MARCH, 2019 | The Health
junior
Snoring kid might
be a problem
The ZZZ’s might be cute,
but it can be a sign of a
serious sleep issue
T
o many of us, our children are everything,
and their health and comfort are a top
priority for every parent. Yet we tend to
brush off snoring as tiredness or maybe as
just an allergy. However, to a certain point,
could it be a cause for concern? This issue,
we speak to an Otolaryngologist/ENT Consultant at
Sime Darby Medical Centre, Dr P Puraviappan on those
troublesome z’s.
“Sleeping disorders can mostly be observed in cases
of ‘sumo babies’, occurring in babies who are identified
as clinically obese,” explains Dr Puraviappan. We often
think sleep apnea only occurs in obese adults but Dr
Puraviappan explains that it occurs in obese children
too.
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Some of the signs
would be frequent
bed wetting at night,
they have restless
sleep in which they
move frequently
at night or sleep in
abnormal positions
with their head in
unusual positions,
snoring and most
importantly they
suffer from learning,
behavioural, or
social problems.”
– Dr Puraviappan
The main culprit
While your child’s gentle snores or little squeaks at
night may sound cute, it is possible that their snoring
may be a sign of a sleep disorder. In children, the most
common cause of obstructive sleep apnea is enlarged
tonsils and adenoids in the upper airway.
More than just losing sleep
A question may arise: What should a parent keep an
eye on to see if their child has obstructive sleep apnea?
To which Dr Puraviappan responds, “Some of the
signs would be frequent bed wetting at night, they have
restless sleep in which they move frequently at night or
sleep in abnormal positions with their head in unusual
positions, snoring and most importantly they suffer
from learning, behavioural, or social problems.”
“Interestingly in adults, they become tired due to
lack of sleep. However it’s the other way around for
children. They become hyperactive instead,” he notes.
How do tonsils and adenoids affect
sleep?
Dr P Puraviappan explains the possible negative
indicator of snoring in kids.
The path that air takes from the nose through the
throat down into the lungs is called the airway. The
tonsils and adenoids form a ring of tissue in the back
of the throat. If the tonsils and adenoids are large, they
narrow the airway and reduce the flow of air into and
out of the lungs.
During sleep, the muscles of the throat relax. Air
flowing through the narrowed space results in a drop
in air pressure. The combination of relaxed muscles and
low pressure causes collapse of the throat and the child
will be temporarily unable to breathe (apnea). After a
few seconds of struggling, the child is partially awoken
from sleep by the apnea, although he or she will usually
not completely wake up. The muscle tone then returns,
and the throat opens- often with a gasp.
A child may go through many of these cycles in an
hour, resulting in a disturbance of the normal sleep
patterns. This condition is known as Obstructive Sleep
Apnea (OSA).
Additionally, it is worrying that the enlarged
adenoids blocks the Eustachian tubes present in the
ear. It presents the child with middle ear infections or
retained fluid in the middle ear. This will in turn affect
the child’s learning and sleep.
First line of treatment
At a young age, in relation to the size of the child’s upper
airways, the tonsils and adenoids are at their largest
relative sizes. A T&A (tonsillectomy and adenoidec-
tomy) procedure is one of the most common and safe
procedure performed on children to help with OSA.
“In the case for children, surgery is the first line of
treatment and the success rates is 80% to 90%,” Dr
Puraviappan assures.
“However I would recommend surgery as one of the
options for adults, as the snoring will make a comeback
after six months.” He adds. — The Health