Paediatrics and Sleep Disorders

This section of our site is intended primarily for General Practitioners, and provides a general overview of Sleep Apnoea in Children.

Sleep Apnoea (SA)  with snoring and sleep disturbance is a common entity in children aged 2 to 7, particularly at times of upper respiratory tract infection when the tonsils enlarge.  SA is most present with sleep disturbances such as snoring, choking during sleep, enuresis, restless sleep, or apnoeic spells. This sleep disruption produces a variety of daytime consequences including:

• sleepiness,
• hyperactivity,
• poor attention span and bad behaviour.
• poor school performance,
• failure to thrive,
• heart failure, and
• cor pulmonale.

Sometimes, the tonsils are big enough to produce this problem every night, even in the absence of current infection.

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If the history is very convincing, and suggests every night sleep apnoea, then GP's referral directly to ENT for consideration of tonsillectomy is warranted. However if there is some doubt, then a Sleep Unit would be happy to monitor such children overnight and try and decide if the benefits of tonsillectomy are likely to outweigh the traumas to a young child of hospital admission and an operation.

Current treatment of sleep apnoea in children consists of largely surgical based treatments. The most commonly used intervention to treat sleep apnoea in children is Adenotonsillectomy (the removal of the adenoids and tonsils), due to its perceived efficacy, cost effectiveness and the relative size of adenoid and tonsil tissue in children.

1. Lim J, McKean M "Adenotonsillectomy for obstructive sleep apnoea in children" The Cochrane Database of Systematic Reviews 2005 Issue 4
2. K W Chau, D K K Ng, C K L Kwok, P Y Chow, J C S Ho "Clinical Risk Factors for Obstructive Sleep in Children" Singapore Med J 2003 Vol 44(11): 570-573
3. Pang K.P. and Balakrishnan A. “Paediatric obstructive sleep apnoea: is a polysomnogram always necessary?” Journal of Laryngology & Otology Vol 118, Number 4, 1 April 2004, pp. 275-278(4).
4. UK Sleep Apnoea Trust  "Guidelines for GP's and Other Doctors" -  Click here to go to the Website.
5. The Royal Children's Hospital Melbourne website has a handy guide for parents called "Kids Health Info for Parents" -- Click Here to download the PDF file

• Telephone 13TOSLEEP (1300 867 533),
• Fax referral to (03) 9832 2295, or
• E-mail bookings@sleepservicesaustralia.com.au

• Click Here to go to our online Request Form; or
• Click here to download our Referral Request Form

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