April 19, 2013
Q: Just wondered what you know about sleep studies for kids. One of the children in my practice sounds like he has some nasal obstruction, but no snoring that the parents have detected, and he is not heavy. So I have my doubts about tonsils, but I have not examined him. Wonder if he is more like UARS? Do you know anything about CPAP for kids? Oh, and he also sleepwalks.
Dr. Smith: No experience at all with childhood epilepsy and OSA. However, yes, I treat children with OSA…had one in today with great parents who both come with him at appointments. Mom was going in to hold his jaw forward for at least an hour every night to get him at least SOME restful sleep. Sleep centers are very comfortable with studies on children. Sleep walking shows no neurological effects or predispositions, so no worries there.
Children do not have to snore at all to have OSA, and when they do, the palatine tonsils are rarely (about 2% of the time) the cause. MUCH more common to have adenoidal obstruction (about 38% of the time, if memory serves), so his nasal obstruction is likely the source. I would get him in to see about the adenoids, then get a sleep study if this does not appear to be the problem. They put CPAPs on small children, but I doubt he will need that.