Sleep-disordered breathing on the rise in children

Sleep apnoea is a sleep condition usually associated with adults but breathing problems during sleep in children are also common.

Breathing problems during sleep in children are common and can affect both health and behaviour. Such problems can vary from simple snoring without impact on sleep or oxygen saturation in the blood, to obstructive sleep apnea (OSA), during which children have repeated episodes of restricted breathing and/or drops in oxygen saturation levels. Although clinical guidelines for treatment were issued in 2012, there is still ongoing debate amongst doctors on the best pathway of care for children. Disturbed sleep in children due to breathing problems can also be caused by large tonsils and adenoids blocking the upper airways. This is called obstructive sleep-disordered breathing (oSDB) and has been the subject of increased research over the past ten years. While milder forms of oSDB are the most common, more severe forms requires tonsil or adenoid surgery. Now, following a comprehensive review, investigators from University College London and the Royal National Throat Nose and Ear Hospital have identified important gaps in how and where children with this condition are best cared for. Dr Anne Schilder says oSDB is a very common condition in children with some evidence it is on the rise:

"This may be in part related to the increase in childhood obesity. Parents and professionals have become more aware that this condition may have negative long-term health consequences and, therefore, it is important that children suffering from this condition are well managed and available resources are allocated appropriately. This means timely treatment of children who need it and avoiding unnecessary surgery of those unlikely to benefit from it."

Professor  Schilder warns that, based on the child's symptoms and signs alone, it can be difficult for doctors to distinguish the more common milder forms of oSDB from the more severe:

"A sleep study is the gold standard but expensive and not widely available. There is no agreement regarding which patients need such a study and how best to interpret its results - that is who needs surgery or medical treatment. There is a need for a more holistic approach to research in this area, taking into account the views of all professionals caring for these children, as well as their parents."

The Irish Sleep Apnoea Trust (ISAT) have conducted a survey in each Health Service Executive area in Ireland in order to identify the locations of specialist medical professionals and sleep clinics that are capable of offering treatment.