Snoring and Sleep Apnoea in Children and Adults

I was watching television on sunday night and happened to change cahnnels and picked up an article on ths Sunday programme (SN) which was focused on snoring and sleep apnoea particularly focused on children.  http://au.news.yahoo.com/sunday-night/features/article/-/18049252/sleepless-nights/ (link for the programme).

Snoring and Sleep apnoea is a major issue in both childrena and adults and unfortunately does often go undiagnosed, I do think though that this TV article was somewhat sensationalised.

When carrying out a check up on both adults and children I will look at the patients throat and tonsillar area.  A dentist is your best first person to check size of tonsils and more importantly can judge the size of the opening of the throat.  Facial shape, soft and hard palate (internal shape of the roof of the mouth) and tonsilar area all play a part in the level of possible obstruction or constriction of the oral cavity and airway.

I would like to make the point that not all adults and children who snore have sleep apnoea (stop breathing). I do if I notice a problem ask the parents to think about concentration levels, behavioural issues, snoring at night, reslestness etc.

As I have been through this process with my three children now ages 7 years, 5 1/2 years and 20 months.  I am particulalry aware of the processes involved and the options open to my patients and my patients parents.

If I feel their is a possible issue in with the constriction of the oral cavity and airway, particularly with the children with big tonsils I will refer them to an Ear Nose and Throat surgeon intially, my preference here is Dr Ian Jacobsen in Randwick.  Ian will on refer generally for a sleep study, as there does need to be evidence of a problem prior to having to put a child through a surgical process.  My preference for the sleep/respiratory specialist and sleep study would be Dr Arthur Teng in Randwick aslo.

I have seen Dr Jim Papadopoulos with two of my children and found him to be expensive and far too sensastionalised making the parent feel there was a greater problem than necessary and causing a greater level of emotinoal distress than necessary.  Dr Papadopoulos would have every child and probably adults in a CPAP machine.

My third child who was very young only 3 months at the time went to Dr Arthur Teng and considering her issue was far worse with the significance of SIDS also a major threat here, he was far more caring and considerate to the parents emotional well being and far less sensationalised about the process, also the process was carried out under the Medicare programme.  Everybody, child or adult is I believe covered to have one sleep study paid for by Medicare for their lifetime.

There is considerable evidence to suggest that if there is an issue with sleep apnoea and after the tonsils and adenoids are removed that the problem will resolve to a satisfactory level.  Sleep paterns are improved, concentration and behaviour improve, I know this from personnel experience.  As parents we are more than capable of monitoring our own children post surgery.

We did not follow up with another sleep study at great expense through Dr Jim Papadopoulous, as after speaking with numerous other specialist collegues they felt it wasn’t really necessary unless as parents we felt the issue had not been resolved, basically has the snoring stopped, are they less restless, is your child less tired, is the behavior improving, can they concentrate more on their work.

I would recommend as parents if your child has large tonsils, constricted airways and snores to have an appropriate referral to an Ear Nose and Throat Surgeon, then referred for a sleep study and possibly try and do this through a specialist who works closely with a public hospital to try and reduce the costs through Medicare.

The reason I like to send my patients first to an Ear Nose and Throat Surgeon (ENT), is often with children the first step of improving airway flow so as to reduce snoring and sleep apnoea is the removal of the tonsils and adenoids, so youw ill end up at the ENT anyway, so they may as well be in the specialist loop from the beginning.

Dr Adam Alford graduated from the University of Sydney, Australia, in 2000 with honours. Dr Alford has worked extensively in Cosmetic and Implant Dental practices in Australia and the UK. He has a special interest in, general dentistry, preventative dentistry, children’s dentistry, cosmetic dentistry, dental implants and teeth whitening. Dr Alford is the author of the article and he maintains a General Dental, Cosmetic and Implant Dental Surgery in the Sydney CBD,  http://www.adamalford.com.au . Webmasters are free to reprint this article provided that it is not edited, the authors information is included, and the links are included as live links. .