Obstructive Sleep Apnea

Hi! My son had sleep apnea, old man snoring, frequent ear infections and extremely enlarged tonsils up until age three when he had tonsils and adenoids removed.

In addition to the sleep apnea, my biggest concern was how little space there was in the back of his throat - his tonsils were so swollen they were almost touching. The ENT took one look at his throat and said he had just admitted a kid to the ER who couldn't breathe because his throat had closed up due to a simple cold. He booked the surgery which got rid of apnea, snoring, ear infections and swollen tonsils.

The surgery and recovery is a bit tough on mom and kid but the outcome after about a week of recovery is well worth it. We did the surgery the Friday before Thanksgiving so I could take time off work - it's about a week of recovery. The pain medicine tastes terrible and it hurts to swallow - try mixing it with pancake syrup (nutrition isn't a high priority when they are recovering from tonsillectomy). Your child may lose weight as she won't want to swallow. My son is now 9 and healthy as an ox.

Good luck.

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Hi Renne,
My son is seven right now. Between the ages of two and five he suffered from sleep apnea. According to the doctors it was caused by his tonsils being very large. The ENT saw him several times and he also had a sleep study done to check how severe his apnea was. It was extremely difficult to listen to him sleep and count the seconds that lasted between breaths. Anyhow, all the time that we saw the doctors, the majority suggested that he needed his tonsils removed, surgery. At the same time they also told us that his tonsils weren't going to grow any bigger, the size that they were, were the size that they were going to stay later on. We had gone through some things with him already so putting him through surgery at an early age was definitely out of the question. He didn't suffer from tonsilitis so other than making noises when breathing at night was going to be OK. I think it was last year when he started breathing normal, without holding his breath in between, and I also stopped counting. We really didn't do anything in particular to make it better, except moving his bed away from a window. Before the bed was next to the window and now it's completely on the other side. He's growing, so maybe there is more space in his throat to breath. Check with your doctor and the specialists and make sure that she's not getting any infections or anything like that. If nothing else is happening maybe she'll grow out of it too. E.

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hello R..

My dentist, Dr. Mamal Rahimi in Los Gatos creates a mouthpiece for sleep apnea. http://rahimidds.com/

I think looking at an alternative to surgery is certainly important. I didn't know this service existed until I saw it in his office.

Dr. Rahimi is a very caring & sensitive dentist, has a wonderful staff & is not pushy about services.

I had some very deep pockets in my gums & he gave me 6 months to work on it rather than scheduling root planing. I managed to improve my gums significantly & didn't need the $1K plus (& very uncomfortable) services.

My son started elsewhere & was always frightened about the dentist. He is very comfortable here & has never complained or balked about coming to this office.

I HIGHLY recommend Dr. Rahimi & his very gentle & caring staff. Feel free to tell them I sent you! ;-)
J. Jackson, Campbell.

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I am a registered nurse and she can stop breathing while sleeping. That is what sleep apnea is. Now, that does not mean that she will not start breathing again, she will, but the numerous episodes of non-breathing throughout the night will effect her heart, her ability to perform the next day and her overall health in general. If her apnea is this severe at her age then she will need a sleep study and will most likely need a C-Pap device. Sleep apnea is serious because it has far reaching effects on our body and lifestyle. Your are to be congratulated for nipping this in the bud at her young age.

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Poor baby! My dad has sleep apnea and my cousin is an ENT so I've become familiar with the problem. My dad is now on an oxygen machine at night that controls his oxygen intake but before he was fitted with it (and waiting for treatment, etc) he found it helpful to sleep propped up by pillows.

Because your child is only 4, she may roll around a bit but overall it might be helpful. And because she is older, she shouldn't have a problem with extra pillows smothering her. Good luck and hopefully the ENT can find a permanent solution for you.

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Hi R....

I'm 36 y/o... and have just FINALLY been DX'd with sleep apnea myself.

I HAD very large turbinates (a little bump that we all have inside our nose... but mine were too large)... and I have HUGE tonsils. Turbinates are reduced with a 2 minute procedure and I can not tell you how much better I breath.

Because I don't get infected tonsils... I'm a good candidate for a reduction of my tonsils... a fairly new procedure... also a quick procedure... mabye requiring sedation (I happened to pass out when they did my turbinates... which was unexpected...so my Dr. will knock me out for my tonsils)... This is a less invasive procedure... with supposedly a sore throat for a day. However, not sure if small children qualify.

Adnoids can be observed (as I discovered at my appt) through a scope that goes up your numbed nose.

OSA has NEGATIVELY effected my whole life... due to absolute exhaustion. It was at it's most severe when I was PG with my twins as I was often gagging for air at night...

I do wish this had been taken care of as a child... of course... Drs ignore SOOOOO much. I started complaining of exhaustion at age 15... I also had a thyroid condition that went unrecognized (the medical community has done me few favors)

So... here's what I would recommend. Get a sleep study done. Or perhaps that's been done since she's been DX'd with sever apnea...(this is sad... she will be disadvantaged at all turns... cranky and too tired to concentrate on anything) Tell your DR. that good sleep is important for the health of your child as well as her cognative development. Ask about a CPAP machine... hopefully she will wear it...maybe you can get her excited about such a thing...You can also get a strap that goes around her chest and an alarm goes off if she stops breathing for a certain period of time. That should wake her just enough to start breathing again... or alert you to the fact that she's not starting up... which is your fear. My cousins son had this strap... keep in mind, if it's not on just right.. it will also alarm... which will scare you!

I realize that your fears are of the worst kind... that she won't wake up... I think you shouldtell her DR. how stressed out this is making you... and effecting your sleep as well... Sleep deprivation is no good for you/DH or her...

If her pedi doesn't address this to your liking... hopefully you have a PPO so you can go straight to a specialist... if not... you need to change pedi's.

Good Luck!!!!

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R.-
As a nurse, and someone who suffers from OSA as well, you definately need to get her checked quickly. She may do well if her tonsills and adenoids are removed, but she may also need to use a CPAP until then to help keep her breathing. She may also need the CPAP after the surgery. I work with some parents who children have OSA and they adapt quickly to the CPAP machine, esp when they realize that it helps them sleep and not feel so tired.
Take care and keep us posted.
P.

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Hi R.,

My 3 1/2 year old daughter has sleep apnea from an obstructed airway. She snores horribly and it is very difficult to listen to her struggle to breath at night and during naps. We took her to an ENT specialist and he determined she needs her tonsils and possibly adnoids removed. We have not yet been able to schedule the surgery, but we are working on it. I have noticed her breathing is especially bad when it is cold and dry out, so I have put a humidifier in her room. I also make sure she sleeps slightly propped up and I always adjust her body if she rolls off her pillow while sleeping.

Hope this helps. Our doctor also told us she would not stop breathing and to trust she will be ok until the surgery, so I have just tried to take their advice and pray they are right. Hope everything turns out ok. The ENT will probably also have some good advice for you!

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Yes, I was so paranoid with my son that I purchased something that was the answer to my prayers. I truly believe that this is the one thing every parent should have.
The Angelcare Movement Sensor with Sound Monitor is $99, available at Target and Babie-R-Us, and worth every penny.

Angelcare Movement Sensor with 2 Receiver Sound Monitor alerts you if absolutely no movement is detected for 20 seconds by an alarm. Sensor Pad detects the slightest movements of your baby, even whey your baby is asleep. Gives you the peace of mind you need to get the rest you need. Stop worrying while your baby sleeps! Winner of JPMA "Show Off" Product Competition. Winner 27th Salon International Invention Geneve Award.

Hands down, this is the best purchase of my life. I no longer worry about his breathing at night because I know that if the worst were to happen, and the alarm goes off, I will know within 20 seconds and be able to do somehting about it before it's too late.

Good luck, and may this bring you and all new moms a much greater peace of mind.

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Hi R. T, My name is D. I have been a Medical Assistant and in the medical field for more than 25 yrs. You may want to talk to her PCP about a Sleep Apnea study done to determine if it is Sleep Apnea and then suggest a CPAP machine for her to sleep with at night. This can be obtain through your insurance co under your DME benefit (DURABLE MEDICAL EQUIPMENT). You can rent or purchase the machine. You may need to get a Authorization from her PCP to have the machine and then contact a Medical supply co. Try this, my fiance sleeps with one everynight and he loves it.

D.

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Hi R.,
My 4 year old daughter was diagnosed with sleep apnea in March of last year. We videotaped her sleeping, brought it to an ENT, and after watching a few seonds of it, the ENT booked her surgery date right then. She got her tonsils and adnoids removed and has been sleeping soundly ever since. The ENT said this procedure cures sleep apnea in kids, although she could still develop it as an adult. Since the surgery, many have said my daughter is "out of the fog" she seemingly used to be in. Her academic, social and cognitive skills have improved dramatically since this surgery as well. I say demand the surgery! Since we have Blue Cross insurance, the ENT we used was Dr. David Arnstein in Los Gatos ###-###-#### and I would highly recommend him. If you have Kaiser, I'll tell you how to navigate that system as well since I work there. Hope this helps!
L. :)

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My son also had sleep apnea and had a very sensitive gag reflex (threw up a lot) when he was 4. Even though the ENT didn't endorse it wholeheartedly, we had his tonsils and adenoids out. He never had apnea again and never throws up anymore - his tonsils were so big it was obstructing his throat. The ENT said my son's tonsils and adenoids were the biggest he had ever seen and was glad we had him take them out. My son is 11 now and it was the best thing we could have done.

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Has the doctor recomended a sleep study with a sleep tech and the possibility of a bi-pap machine while sleeping? My daughter sleeps with one and I have peace of mind that she is getting the support she needs while sleeping, it kicks in a breath for them if they stop or miss one. I would suggest that you maybe see a pulmonologist (lung physician) not because there is anyhing wrong with her lungs but just because they are usually familiar with the Bi-pap machines, sleep tech.'s & have sometimes in the office Respiratory therapists. The more support and answers you get the better. If you need anything else contact me again.Good Luck
K. in Californa single mom of adorable 41/2 year old girl.

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Hello,
At my son's 5 year well visit I told our pediatrician how my son snored all through the night, often gasping/choking before breathing again and how scary it was and how he was never well rested and neither were we! This started around age 4. He also grinds his teeth fairly harshly at times and has occasional bed-wetting because he cannot wake up. As the others responded; the pediatrician said there was no danger in the short run but that it could affect his heart later on. He recommended having his adnoids and tonsils out which we still have not done. I have enlarged tonsils and have always been a mouth breather. I have heard as teenagers it is possible the size of their adnoids even out-but if not, and you have to have them removed-it is a much riskier procedure than at a young age.
It is not an easy decision-and I am interested in hearing more about the antibiotics and other forms of treatment out there that others responded with and what you find successful in your endeavors. Does anyone's child who has sleep apnea also have speech issues? My son has trouble saying certain sounds
such as "cr" he pronounce "tw" and some others as well. I know tongue placement has to do with it and am wondering if the tonsils and adnoids can also be connected? Anyone with experience in this?

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Here is a website I found that has some great information (Ive never had experience with pediatric sleep apnea, only adult - runs in my family):

http://www.entnet.org/KidsENT/apnea.cfm

If the doctors haven't suggested it already, the ent will probably suggest your daughter have her tonsils out - swollen tonsils is often a main cause of obstructive sleep apnea in children, unless there is an excessive weight issue.

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Hi R....

My husband has sleep apnea...and will not consider a machine...anyway...he had an accident almost two years ago...and given his injury we got a recliner for him to sleep in...it was amazing..the angle/elevation solved his whole problem...no snoring...no gasping for breathe...you might want to try one of those bed wedges...see if it will help...I was amazed something so simple worked...T.

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I had heard a while back that Stanford has a sleep clinic and are studying and treat this disorder. Maybe google it. Hope this helps. TJO

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Hi R.,
Just has to respond to your inquiry. I have two daughters, 9 and 7. My seven year old had major sinus infections when she was younger and also sleep apnea. We brought her to Doctor Arnstein in Los Gatos (ENT) and he said her adnoids and tonsils needed to come out and they were acting as a reservoir and not a filter so that is why she was not able to get over the sinus infections on her own. She also used to snore in addition to the sleep apnea (about 10 seconds on not breathing). She had the surgery about three years ago and hasn't had a sinus infection since. She also grew about 4 inches. The first night after the surgery, we didn't hear a peap out of her. I kept going in her room to check on her and she wasn't making a sound and no sleep apnea even on the first day when I though her throat would have been swollen. Feel free to give me a call with questions. I know this can be very frightening.
E. ###-###-####

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Hi R., I recently took my 4-year old to an ENT specialist for the same issue; however, I learned a bit more about sleep apnea and her symptoms, so hopefully this will help ease your mind. The doctor was right; your child will not stop breathing while asleep. Your child may simply have a severe sinus infection that's causing the breathing difficulty or may have enlarged adenoids, which block the passage for proper breathing. In both cases, it is treatable. Like you, I was very concerned for my daughter, because (in general) I see that she primarily breathes through her mouth (at all times). Our next step, per the ENT doctor, is to videotape her asleep at night (for about 30 minutes) and drop off the tape to the doctor to view with us. Our daughter had the same sleeping pattern you described, but then she added a little teeth grinding to it. We have had her on two different antibiotics and this second one, we think is helping with her breathing. At least now I see that she is able to breathe through her nose more easily and we encourage her to blow her nose as much as she can (when we hear the obstruction in her breathing). We have a follow-up appt., but at least now I feel more calm that this is not as serious as I thought. Having talked with other mothers about it, I discovered that it is fairly common with this age group and that a last result would be to remove the adenoids. (By the way, I had mine removed as a child for this very reason.) Hope that helps!

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my son I felt had sleep Apnea, he is now 18, but when he was in 1st grade we had his tonsils and adnoids removed and he has been great ever since....

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Hi R.

I had to respond as I have a 14 year old son who had severe sleep apnea and at 4 we had to have his tonsils and adenoids out to cure the apnea. We were told that they wanted to do the surgery before Kindergarden because they found that children with apnea did not perform well in school as they were over tired.

We did not find that anything really helped the apnea other than having the tonsils and adenoids removed, and even then it took some time after the swelling went down from the surgery before he improved.

It used to scare me every time I heard the long gaps between breaths. He was fine though. I would push for your appointment with the ENT and ask him to do the surgery asap, remind him that your child will be entering school soon and so would benefit from doing surgery sooner rather than later.

Good luck

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Hi R. -

My daughter also had sleep apnea - we found a great ENT dr. who did surgury. Our daughter had her tonsils and adnoids out and she is one quiet sleeper now. It was an overnight difference. Before our appt. we video taped our daughter sleeping so he could see first hand how severe it was. That way we didn't have to wait to do a sleep study somewhere - good luck.

A.
Napa

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Going to see the ENT is the absolute right step. I'm 99% sure that they will tell you that your daughter will need to get her tonsils and/or adenoids removed. In children, the main cause of sleep apnea is enlarged tonsils and/or adenoids. I know this because my nine year-old twin boys were just diagnosed with sleep apnea, and the ENT said that 90% of the tonsilectomies/adenoidectomies she does in children are for sleep apnea. They both had the procedures done this December, and boy, what a difference... no more snoring, no sleeping with their mouths open, no more teeth grinding, and they are so much more alert and calm during the day now, because they are finally getting good, deep REM sleep.

I sooo want to jump on my soap-box and tell every parent I know about this, because most parents have no idea what sleep apnea is (we sure didn't!) After a long struggle with ADD-type symptoms (we had just taken one of our boys to see a psychologist to find out if he had ADD) their orthodontist (of all people!) discovered that they had enlarged tonsils, and asked if the boys were displaying ADD-type symptoms, because sleep apnea symptoms can mimic that.

You will be so happy and amazed at how much better she will sleep once you get the procedure done (if the tonsils and adenoids are, in fact, what is to blame here) The recovery process is a bit hairy (my boys were hurting for about two weeks) but, man, oh man... what a difference. And the fact that you discovered this when she is only four is a blessing too, because apparently, over time, sleep apnea can cause developmental problems, both physically and mentally. I can attest to the psycological symptoms... I had one boy who was totally hyper-active, and one who seemed to be in a total fog, and had short-term memory problems. (It was interesting to see how the lack of sleep affected each one differently, given that they are identical twins). The ENT said that sleep apnea can also stunt their growth (because children do the majority of their growing while they sleep) and that it can even effect the development of their jaw. Because since they are sleeping with their mouths open, the jaw is not held in allignment like it would be if they were sleeping with their mouthes closed, and the upper and lower jaw might then grow at a different rate, causing either an overbite or underbite. Crazy, huh?!?

Sorry to go on and on about this, but I am so passionate about this problem, because if it has not been for our orthodontist, we would have never know this was going on. We didn't see that there was a big problem with the fact that the boys would snore. I now know that snoring is BAD... it means that there is something wrong, some type of obstruction of some kind, and that ANYONE that snores should go to an ENT to be checked, because there is an underlying problem that should be addressed.

Good luck with your daughter! If you are in the Menlo Park area, I can recommend an amazing ENT if you are interested.

-S.

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Hi! That must be so tough to deal with! I don't know a lot on the subject, but my brother-in-law has been living with that all of his life (35 years). He has tried various medications, and has been useing one of those sleep masks for years. He has never been able to breate through his nose and has recently found an ENT doctor who believed that it could be solved with a simple surgery. Yesterday he had that surgery and was able to go home last night. The doctor said that his septum was bent at a 90 degree angle and he had never seen one that bad, but the surgery went really smoothly. Now he will have to learn to breathe through his nose, but the doctor thinks this will make him "normal". We are all very excited to see if it works!

Good luck! I think you are on the right track with the ENT.

D.

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R.,
My daughter was the same way. She would snore and stop breathing and wake herself (and me) up many times throughout the night and was always exhausted. I actually wore earplugs to drown out the noise.
Right before she started Kindergarten, the massive tonsils and adenoids were removed.
My daughter was and is a different girl!
Aside from being irritable and tired a lot, she suffered no ill effects from the apnea. I didn't want her to start school with so much fatigue and the "growing into the tonsils and adenoids" was not going to happen in her case.
See what your ENT has to say and relax.
Janie T.

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There is a device upon which the kids sleep which will monitor breathing; stop breathing an alarm goes off. Not usually available in USA because of product liability but I bought one in the Czech Republic and it works great!
Probably also available in any EU country.
PB

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Hi R.,
How scary for you! Remember she is young and healthy, otherwise, and her body will respond and wake her to breath. If you are really concerned ask her doctor for a monitoring device that would alarm if she stopped breathing, if insurance won't pay for it see how much it costs to rent, just to give you peace of mind. I want to stress that this is probably mostly for your peace of mind, but that is important for you and your family. A mommy with no sleep can't do what she needs to do!

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Hey R.-

Sorry to hear about your problems with your daughter.

I understand how you feel. My son has struggled with sleep apnea; to the point he was to afraid to sleep. He has continued to sleep few hours a night. I, too, have seen several doctors about his issues. They let me know he would “out grow it” down the line (which never happened). This was at the age of 2. He never napped. He would just drop, whenever his lack of sleep caught up with him. (??)

Whenever the apnea kicked in, he’d always wake up and breath again- on his own. But is was definitely scary. His body always kicked him awake gasping for air, when needed. (??) There have been a few times he didn’t come all the way awake, leaving him in this weird half awake half asleep state. Creepy! But that’s a whole nether story.

Alex is now going on 13; and still deals with insomnia (as he is now diagnosed) with a side order of apnea (smile). Recently the dentist felt the apnea and insomnia issues are related to his jaw (causing the problems). His jaw isn’t lined up well (his lower jaw is to far back), leaving a narrow passage way; causing lack of air flow as he sleeps. (??) He is now in braces, hoping to help clear the problems. We will see...?? They didn’t want to simply remove his tonsils and glands. The doctors feel we really need to keep them in for better health. (??)

Is it possible your daughter has a small or narrow breathing passageway, too? It isn’t a problem with Alex when he is in the up-right position. Only when he is laying down. Especially on his back (which he goes to in his sleep at night). By the time his head is relaxed (asleep), his jaw “falls back” into his throat. Narrowing his breathing passageway; causing his apnea. (??) So they now think.

A little about me:
I am a 35 y.o stay-at-home mother of 4 (Ages: 15, 13, 10 & 9).Three girls and 1 boy. My youngest has many disabilities due to a traumatic brain injury @ age 2. I teach all 4 children through the Mountain Oaks Charter School (state affiliated home school). I teach grades 3rd, 4th, 7th & 9th .

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My son had sleep apnea and we had his adnoids removed by the ENT and that fixed the problem.

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My grandson had this and ended up having his adenoids removed. They were very large and he was helped a lot after the surgery.

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