Blocked Breathing and Sleep Apnoea

Sleep apnoea can cause children to miss out on getting the restful sleep that they need—prohibiting the child’s ability to learn and concentrate. Thankfully, Lily, children’s ENT consultant, has some helpful tips.

What is blockage of breathing when asleep (sleep apnoea) in infants?

Sleep apnoea is when the muscle tone in a child’s throat relaxes as they sleep, leading large tonsils to fall in and block the child’s breathing. Once it blocks, the child wakes to some extent, causing the muscle tone to return, and so their breathing clears. The child takes a big gasp and changes position, trying to go back into the deep sleep. The problem is, the child will keep missing that deepest, most restorative part of sleep.

What is usually the cause of the problem?

Most often, in children, it is large tonsils at the back of the throat along with large adenoids blocking the back of the nose.

How can the issue be prevented, if at all?  

Unfortunately, we do not know of a way to truly prevent it. Salt-water drops in the nose at night may help keep a child’s nose clearer. However, this doesn’t change what is most-often the underlying problem.

How can parents watch out for it—what are the signs to be aware of?

Most often, as above, children snore and then catch their breath (an apnoea) whilst asleep. They then make the increased effort to breathe, change their position and gasp for air. The pattern then repeats itself.

Would you advise having a baby monitor in the bedroom to check for irregular breathing?

Yes. Baby monitors do not do any harm and help parents to check on babies and very-young-children’s breathing.

What methods can be used to treat the problem?  

Tonsils and adenoids can be reduced in size to make more room for breathing. Nowadays, this is done by a less invasive (coblation) method (compared with the traditional method used until five years ago). Tonsils and adenoids are effectively shaved away with electricity so that the underlying muscle is left undisturbed. A small amount of tonsil is left behind on the muscle, accounting for much less pain in the recovery period. A decision on whether surgery is appropriate is made very carefully, depending on the situation of each individual child.

What knock-on effect can a lack of a good night’s sleep have on a young body and mind?

Mainly, it is to do with being rested and fresh for the next day. If sleep is disturbed, for example by sleep aponea, then children can either be hyperactive or sleepy the next day. Concentration and learning can be reduced (same as for an adult who has been up all night trying to help their child sleep!).

How many hours of sleep should a child get and does this change over time?

Clearly, more sleep is best for everyone, though extremely hard to achieve and the amount needed for each child certainly changes over time. Babies, for example, have regular, short sleeps every couple of hours—sometimes for as little as 20-30 minutes (and even those feel like an achievement for parents). Toddlers, on the other hand, can sleep for more than 10 hours at night and process everything that has happened that day (though they’re often keen on a very early start to get on with the next one!)

Why do children need more sleep than adults?

That is a great question. I believe that it is because each day children are laying down new memories as they go about learning an enormous amount and their brains are rapidly developing.

What is the best way to get a child off to sleep?

There is no magic way. A routine is the best we can do but, as we all know, our children may have their own opinion on whether it is time for bed!

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