Treatment

Not only are the diagnostic criteria different in children than adults but also the treatment options. SDB in adults has four treatments options which may be combined. The most common treatment is continuous positive airway pressure (CPAP) to help splint open the upper airway (see also Chapter 6). When CPAP is used correctly snoring should be absent during sleep. There are several sophisticated surgical options with a wide range of success (see also Chapter 11). In adults, oral appliances, which help reposition the mandible, have improved breathing during sleep in selected patients (see also Chapter 12). As a conservative measure, adults with SDB are advised to sleep off their backs, lose weight, and avoid alcohol before sleeping (see also Chapter 13).

Unlike adults, in children surgery is the most common treatment for SDB. Adenotonsillectomy is the most common initial treatment for SDB in children (Fig. 3). This procedure can be extremely effective and result in dramatic improvements (and very grateful parents). When surgery is being entertained, as a general rule, the adenoids and tonsils should both be removed during the same surgery. It is tempting in very small children to only remove the adenoids if the tonsils do not appear overly enlarged since this allows for less postoperative pain and lower risk of adverse events such as bleeding. This practice should be discouraged since even though the tonsils do not seem enlarged the surgeon must keep in mind that they are examining a child that is awake and sitting. The relative posterior airway space

Sleep Apnea

Sleep Apnea

Have You Been Told Over And Over Again That You Snore A Lot, But You Choose To Ignore It? Have you been experiencing lack of sleep at night and find yourself waking up in the wee hours of the morning to find yourself gasping for air?

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