Pediatric Services

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• A good quality of sleep is  crucial for your child's growth and development.  

NORMAL SLEEP IN CHILREN:

• Newborns: 12-16 hours divided in short sleeping periods. 
• Infants, Toddlers, Preschoolers: 11-14 hours, including naps
• Kindergartners - 8th graders: 9-10 hours
• 9th - 10th graders: 9.25 hours
• 11th -12th graders: 8.5 hours

It is estimated that between 1 to 5 percent suffer from pediatric sleep apnea, it can occur at any age but many of them being between 2 and 8 years old.

 The most common underlying condition is enlargement of the adenoids and tonsils which contributes to narrowing of the airway. Obesity may also play a role children. 

Other underlying factors can be craniofacial anomalies and neuromuscular disorders. 

• Snoring during sleep
• Noted pauses in breathing
• Mouth breathing
• Bed wetting
• Night terrors
• Irritability
• Difficulty focusing/concentrating
• Hyperactivity
• Restless sleep
• Perform poorly in school
• Difficulty paying attention
• Behavioral or learning difficulties
• Have poor weight gain
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• Down syndrome
• Abnormalities in the skull or face
• Cerebral palsy
• Sickle cell disease
• Neuromuscular disease
• History of low birth weight
• Family history of obstructive sleep apnea

In addition to a consultation with a pediatric sleep specialist, an overnight sleep study (Polysomnogram), is the only tool for a definitive diagnosis and assessment of the severity of pediatric sleep apnea. 

• Surgery-Tonsillectomy and Adenoidectomy
• Mandibular Expanders or Oral Appliance Therapy
• CPAP Therapy
• Weight Management

Surgical removal of the adenoids and tonsils is the most common treatment for pediatric sleep apnea. In uncomplicated cases, the operation results in complete elimination of OSA symptoms in 70 to 90 percent of the cases. 

If adenotonsillectomy is not indicated, or if the surgery does not fully resolve the symptoms, positive airway pressure therapy (PAP) like that commonly prescribed for adults probably will be helpful.

Oral appliances for treatment of pediatric OSA are helpful in some cases, especially in adolescents whose facial bone growth is largely complete. 

Weight management, including nutritional, exercise, and behavioral elements, should be strongly encouraged for all children with OSA who are overweight or obese. An adequate nightly duration of sleep is an important component of weight management.