Sleep aponea: an expert guide

Written by: Mr Amit Parmar
Edited by: Aoife Maguire

Sleep apnoea is a condition where children experience pauses in their breathing during sleep, often accompanied by gasping or coughing. One common form, obstructive sleep apnoea (OSA), occurs due to blockages in the airway, frequently caused by enlarged tonsils and adenoids.


Leading consultant ENT surgeon Mr Amit Parmar provides a guide to sleep apnoea in children, including symptoms, diagnosis, treatment options and lifestyle changes.




What are the common symptoms of sleep aponea in children?


Sleep aponea is a condition where children have pauses in their sleep.  They can also gasp or cough for breath. 


There is a form of sleep apnoea know as obstruction sleep apnoea (OSA ) – this is where the sleep apnoea is caused by an obstruction, often this is caused by large tonsils in the mouth and adenoids at the back of the nose.


With obstructive sleep apnoea the child may have any of these symptoms, Snoring, disturbed sleep, restless sleep, waking up at night, gasping and coughing, sleeping upright, sweating, frothing and headaches. During the day the child may be tired, hyperactive or irritable


How is sleep apnoea diagnosed in children?


Obstructive sleep apnoea can be diagnosed by taking a detailed history and undergoing a careful ENT examination.  During the examination the oral cavity will be examined for the size and obstructive nature of the tonsils, the position of the tongue and jaw.  A nasal examination will help to determine the size of the nasal turbinate’s, shape of the septum and provide an assessment of the level of nasal obstruction.


In certain circumstances a sleep study may help in the diagnosis of OSA. 


What are the treatment options for sleep apnoea in children?


The treatment depends on how long the symptoms have been present for, how old the child is and what the cause of the obstructive sleep apnoea is?


In cases where the obstructive sleep aponea hasn’t improved with time the child may benefit from surgery on their tonsils and adenoids.  There are various surgical approaches for surgery such as co-ablation and bipolar. Laser tonsillectomy in children should be avoided due to the increased risk of bleeding.


Can sleep apnoea in children affect their behaviour and learning?


There is significant research which shows that obstructive sleep apnoea effects day time behaviour.  Having interrupted sleep prevents children from being rested by disturbing their REM sleep.  REM sleep is essential and the most important phase of sleep for development. 


Having disturbed sleep results in a child who is tired and irritable, which can also present as hyperactivity.  Being tired can affect learning and education development.  Many years of untreated Obstructive sleep apnoea can also result in pulmonary hypertension and cardiac strain


Are there any lifestyle changes that can help manage sleep aponea in children?


In some cases where sleep aponea is caused by being overweight. A programme of weight loss can result in an improvement in symptoms.




If you would like to book a consultation with Mr Parmar, do not hesitate to do so by visiting his Top Doctors profile today.

By Mr Amit Parmar
Otolaryngology / ENT

Mr Amit Parmar is a leading consultant ENT surgeon based in Birmingham who specialises in paediatric airway, head and neck surgery, providing treatment for obstructive sleep apnoea, tongue-tie, sinusitis, tonsillitis and neck lumps. With over 15 years’ experience, Mr Parmar sees both adult and paediatric patients, and performs microsuction and nasendoscopy procedures as well.

Mr Parmar, who consults privately at Midland Health clinics and at Spire Parkway Solihull, originally qualified from St Bartholomew’s and the Royal London School of Medicine with distinction. He completed his initial medical school training at renowned institutions, including at Great Ormond Street Hospital and at Melbourne Eye and Ear Hospital, before going on to accomplish higher specialist training on the prestigious Severn deanery. This training programme included rotations in Bristol, where Mr Parmar developed proficiency in ENT and head and neck surgery. In 2016, Mr Parmar was awarded with a highly sought-after fellowship in ENT surgery, to be undertaken at the Princess Margaret Hospital for Children in Australia.

As a prominent figure in his specialty, Mr Parmar is currently the lead of the paediatric ENT team at Midland Health and an NHS consultant ENT surgeon at Birmingham Women’s and Children’s Hospital. He is a fellow of the Royal College of Surgeons (London) since 2015, and is also a recognised trainer and otolaryngology expert on the GMC’s specialist register. With an additional interest in leadership, Mr Parmar also has an MSc from the University of Birmingham, and is a GMC-recognised educational supervisor for trainee ENT surgeons.

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