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Snoring and Obstructive Sleep Apnea (OSAS) in Children

Sleep is an important human behaviour. A dequate sleep is important for  human beings to function properly in their daily activity. Adequate sleep is important for children in terms of duration and quality so that they can grow, develop and function properly.

Obstructive sleep apnea syndrome is a form of sleep disorder found in children. It is due to obstruction of the upper airway during sleep resulting in   inadequate air reaching  the lung during breathing. Air contains oxygen which is a very important element for the  proper function  of the organs especially the brain. Inadequate oxygen will cause many body organs unable to function properly.

The obstructed upper airway will produce snoring sound during sleep. Around 10% of children frequently snore during sleep. However only 10 -20% of them have OSAS.

Airway and lung

Causes and risk factors of OSAS

OSAS is due to a significant obstruction of the upper airway during sleep.  In normal children, the obstruction can be due to  either enlarged adenoid tissue or enlarged tonsil or both. In obese children, the increase amount of fat tissue around the upper airway also contributes to upper airway obstruction.

In children who have abnormal shape of the face like Down syndrome, it results in narrow and crowded space of the upper airway causing it to be easily obstructed during sleep.  In children with muscle disease such as muscle weakness the airway is easily obstructed since the muscle cannot prevent the airway from collapsing during breathing

Other risk factors for OSAS in children are exposure to cigarette smoke, history of asthma or allergic rhinitis, recurrent tonsillitis and being of male gender.

However in some children there is no obvious explanation why the upper airway is obstructed during sleep.

When to suspect your child is having OSAS

The main symptom is snoring. Other sign and symptoms are:

Complications of OSAS

OSAS can cause long-term complications. This include :

Treatment and Prevention

Children with OSAS can be treated appropriately according to the causes.  However they should be seen by doctors in order to assess the severity of the OSAS. These children may need a few investigations to confirm OSAS and to look the effect of the OSAS.  Some of these children may need sleep study to confirm and to assess the severity of OSAS.

Treatment depend on the severity and these include operation to excise adenoid and tonsillar tissue (adenoidtonsillectomy), using breathing machine (CPAP and BiPAP machine), weight loss or nasal spray.

OSAS can be prevented by having good habit such as proper dietary habit that prevent obesity, regular exercise, do not smoke, proper treatment of allergic rhinitis and asthma.


Parent should aware that if their child snores during sleep, there is possibility that their child has OSAS and thus need further assessment.  OSAS that left untreated can affect the health of the children.

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