SLEEP APNEA IN CHILDREN IS FREQUENTLY TREATED WITH REMOVAL OF TONSILS AND/ OR ADENOIDS. ORTHOPEDIC APPLIANCES AND SLEEP APPLIANCES ALSO HAVE A ROLE.

Dawn: My 5yo daughter had T&A sx at 22mos which seemed to help her osa up until about 8months ago. She is now going to start using a cpap for severe osa. I now know she will need orthodontic and/or maxillofacial close monitoring. I am wondering if any of thes oral applianced are used with children this young also, and if there is anyone in the northern ******** area who is best trained for this.

Dr Shapira: Dear Dawn,

There is an excellent Sleep Apnea Dentist in your area Dr *********** I just talked to him and he would be happy to work with you and your daughter. If there are any questions during treatment we can discuss it as treatment pprogresses.

There would actully be two appliances involved a nightime appliance and a daytime appliance. This will allow the widening of the maxilla while using an appliance to prevent apnea...Dr ******* has a great deal of experience in treating sleep apnea.

This will not only treat the sleep apnea but begin treating the underlying orthopedic problem. You child will still need orthodontics (probably) in the future but the early orthopedic therapy will make future orthodontics easier.

MORE ON THIS TOPIC: SLEEP APNEA IN CHILDREN IS FREQUENTLY TREATED WITH REMOVAL OF TONSILS AND/ OR ADENOIDS. ORTHOPEDIC APPLIANCES AND SLEEP APPLIANCES ALSO HAVE A ROLE IN TREATING CHILDHOOD SLEEP APNEA TREATMENT.

There is a question whether tonsilectomy and adenoidectomy should occur before of after widening of the maxilla. Widening the maxilla will improve the airway and possibly lower post-op complications. If T&A is done prior to widening studies have shown that it does not correct the development orthopedic problems. All patients should be reevaluated for sleep apnea and for maxillary expansion.

# year old with (OSA) Sleep Apnea. Are there alternatives to tonsil and adenoid removal

comments : my 3yr old grandaughter has been diagnosed with OSA, they are referring surgery to remove adenoids & tonsils. would like to know if there are any alternatives out there. we are going to try the oxygen therapy 1st. is there anythings else we can do

This is an interesting question for several reasons. The first is that they have discussed oxygen therapy, unfortunately oxygen therapy is not helpful for obstructive sleep apnea because the airway is obstructed and therefore the oxygen does not get to the lungs.

The second part of the question is there an alterrnative to tonsil and adenoid removal. Rapid maxillary expansion can open the airway in children and is often indicated IN ADDITION to removal of tonsils and/or adenoids. A Swedish researcher suggested at the Dental Sleep Meeting that doing maxillary expansion prior to surgery make reduce complications and create easier and/or faster healing. Another recent report has shown that even if tonsils and adenoids are removed there will remain orthopedic jaw problems that will still usually require widening of the palate.

The question which should be done first surgery or widening of the maxilla is still open.

What is not open is that pediatric patients with sleep apnea should be treated ASAP. ADD, ADHD and other learning and behavioral disorders have been linked to pediatric sleep apnea and time is of the essence.

Various studies have shown delayed brain development and/or permanent changes in brain development as a consequence to sleep apnea in children. Read the story in my profile about my sons sleep apnea and how treating it changed his life.