Treatment for OSA in children
OSA is a treatable condition and if your child is diagnosed with it there is lots of help available.
These are the options available to treat OSA in children.
Nasal inhaled corticosteroid sprays or drops
Nasal inhaled corticosteroid sprays or drops may be helpful in mild OSA or when an operation to remove the tonsils and adenoids (adenotonsillectomy) has not been completely successful. They are particularly useful if the child has associated allergic asthma or other allergy-related conditions.
Children of pre-school age might have difficulty accepting sprays squirted into their nostrils and may do better with drops.
If your child is overweight or obese, weight loss is an essential first step to controlling OSA.
Adenotonsillectomy is an operation to remove the child’s tonsils and adenoids. It has a high success rate for treating OSA in children who are otherwise well.
Some centres will only carry out this procedure after an overnight study has confirmed the diagnosis. Others will go ahead with the operation if the diagnosis is clear from taking a medical history and examining the child.
Removing the tonsils and adenoids may not cure OSA in children with a small chin, large tongue or cleft palate, in obese children or in those with other health conditions.
Continuous or bi-level positive airway pressure (CPAP or BiPAP)
CPAP or BiPAP is an effective treatment for a small number of children with OSA. It is a simple machine that pushes air through a mask worn at night to keep the airway open. The machine uses ordinary room air and is powered from the home electrical power supply. CPAP machines have one pressure setting. BiPAP machines can be set to different pressures for breathing in and breathing out.
Children usually find it surprisingly comfortable, but the fitting and follow-up should be planned and managed by a specialist respiratory paediatric team.
In a tracheostomy, the surgeon creates an opening in the neck at the front of the windpipe which your child can breathe through at night. This is only used in cases of very severe OSA, usually in the context of other medical conditions and if all other options have failed.
Oral jaw repositioning devices.
This option could be considered for OSA in children with malocclusion of the jaw – when your child’s upper and lower teeth don’t meet properly when they bite, for example when the lower jaw is set back.
What about sleep position?
Opinions vary about how important sleep position is in children with OSA. Some studies suggest that OSA can be worse when a child sleeps on their back.
But others suggest that sleeping on their back can help. More research is needed. Ask your doctor for more advice.
What happens if OSA isn’t treated?
It is important that OSA in children is diagnosed and treated. Untreated OSA has been linked with:
- poor growth or weight gain
- worsening behaviour, hyperactivity and aggression
- poor or impaired performance at school
- poor quality of life
- risk of high blood pressure or heart disease