Surgery recommended treatment for sleep apnea in children

Less commonly known: obstructive sleep apnea syndrome (OSAS) is also a common problem in children.

Dr. Jolene Meis, a pediatrician at Medical Associates, and other experts estimate somewhere between 1 and 3 percent of children suffer from sleep apnea, which is a sleep disorder making breathing at night problematic due to an obstructed airway.

"Something is in the way and you can't get any air in when you try to breathe at night," Meis said. "In children the most common cause is large tonsils and adenoids."

Generally, the most accepted treatment of choice for OSAS in children is the removal of tonsils and adenoids, Meis said.

She said understanding why some children have sleep apnea due to the enlarged tonsils and adenoids is unknown, but there are certain traits parents can look for if they are concerned.

Overweight or underweight children, those that snore or have restless sleep are common symptoms, Meis said. Other symptoms include the inability to concentrate at school, more aggression and irritability than usual, bed wetting and night sweats.

"They're not getting enough sleep," Meis said. "When kids get fragmented sleep in other words when they're waking several times a night, they just don't get quality sleep."

Meis said children with sleep apnea don't normally complain of daytime drowsiness as adults with the condition often do.

"We see more neurocongnitive behavior in children" she said. "They just can't sit in a classroom and focus on their work when they're too tired."

Meis said sleep apnea in children is common everywhere, but it may be more difficult to diagnose here because it has to be confirmed by a sleep study. The closest sleep study facilities are in Sioux Falls, S.D. and Omaha, Neb.

"It's a little bit difficult to get a diminutive study around here because we just don't have the availability and the expertise," Meis said.

She bases her diagnosis on the child's behavior, history of snoring and whether tonsils and adenoids are enlarged.

"If I think it's suspicious I send them to an ear, nose and throat specialist," Meis said. "If they think it's justified, they go ahead and take the tonsils out."

If that doesn't cure the problem, the next treatment option is to sleep with a special nasal mask called CPAP (continuous positive airway pressure).

CPAP uses an electronic device to deliver constant air pressure and assure continuos breathing, but Meis said it is difficult for children to use this method.

"They don't like the mask. They are claustrophobic. It takes a lot of medical followup to make sure you are in compliance of it," Meis said. "It takes a lot of training."

But Meis said, children can adapt and if parents work with them CPAP is an option, but surgery is the best treatment.

Sleep apnea has always been a problem, Meis said, but it was only in the last few years that it has been recognized.

This week March 3 to March 9 is National Sleep Apnea Awareness Week.

As part of that, A.W.A.K.E. (Alert, Well and Keeping Energetic) of Le Mars is hosting its annual National Sleep Awareness Day program from 7 to 9 p.m. on Tuesday, March 11 at Floyd Valley Hospital's Conference Room Number 1.

A.W.A.K.E. of Le Mars is a health awareness group open to anyone with sleep apnea. The purpose of the group is to provide support to people affected by sleep disorders.

The public is invited to learn more during a free program beginning with a talk "Understanding Sleep Apnea" by Dr. Thomas Kenny, an ear, nose and throat specialist, Meis will follow with a presentation called "Symptoms of Sleep Apnea in Children" and "Sleep Patterns for Children."

People can call 712-546-3401 or 800-642-6074 extension 401 to preregister.