Agree
Thanks
Ear Nose and Throat (ENT) Surgeon
At least 80% of childhood snoring will be cured or improved by removing the adenoids and tonsils. The remaining snorers have other causes such as central apneas or hypotonia (weak muscles) but this would have been detected in the sleep study. A normal sleep study is very reassuring and means that your child does get proper sleep on some occassions. Ask why he slept so well on that night? What did you do differently? most people sleep worse when they have all the devices attached to them.
We are also seeing adult like snoring in chldren who are overweight. Our approach is the same as for adults, start by maximising nasal function (good nose breathing) and weight loss.
We are also more proactive in managing children with nasal obstruction who fail steroid sprays and have had an adenoidectomy. We have had good success surgically addressing the turbinates and residual intranasal adenoids.
Also remember that issues falling asleep are not the same as sleep apnea. Watch you chlid sleep at different times of the night on different days. Try and see if his snoring is positional, associated with colds or blocked nose, if it occurs all night or only at certain times. All this information is very useful for your treating doctor.
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You can find out more about children and sleep on the Sleep Health Foundation website here.
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Speech Pathologist
I agree with Dr Kalish's detailed answer to this question and would like to chime in a little on the ‘muscle’ component of his answer. I am not sure how old your son is (5 years old?), but fequently children who have had large tonsils and adenoids, have developed orofacial muscle habits including: forward tongue posture for rest position and various functions, swallowing chewing speech and breathing. These muscle habits do not change automatically after the tonsils and adenoids are removed, and are often seen in conjunction with weak or low slung oropharyngeal and nasopharyngeal musculature. The pharyngeal muscles are in the region at the upper/back of the mouth/nose where snoring can occur. If this is the case with your son, some exercises to retrain these orofacial muscles and habits can help with snoring.
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Ear Nose and Throat (ENT) Surgeon
As an ENT, I used to think we had all the answers with surgery, but as time has gone by I have come to appreciate the importance of team work and having a wholistic approach. There are many things you have mentioned that new research is helping us help kids better than we could before.
www.entspecialists.com.au
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