Snoring and Obstructive Sleep Apnea

Children often suffer from OSA for a variety of reasons. These include blocked nose caused by allergy, sinusitis, large adenoids, pharyngeal obstruction from tonsillar enlargement, small lower jaw (retrognathia) causing base of tongue to prolapse backwards and shutting off the airway.

The most common ENT cause is large tonsils and adenoids. When significantly large, it causes

  1. Loud snoring
  2. Choking spells during sleep, with apneic spells (periods of no breathing)
  3. Drooling while sleeping
  4. Restless sleep (frequent tossing and turning)
  5. Nose blocked
  6. Mouth breathing
  7. Difficulty swallowing
  8. Coughing, choking during meals

Associated symptoms include

  1. Behavioural Changes eg irritability, temper tantrums
  2. Poor concentration
  3. Poor School and Work performance
  4. Ear infections, hearing loss from otitis media
  5. Frequent flu, sinusitis

On examination, the tonsils can be seen through the oral cavity. Large obstructing ones are called kissing tonsils. Adenoids have to be examined with a nasendoscope.


  1. Large tonsils and adenoids are easily surgically removed.
  2. Sinusitis, allergy must be treated medically and treated aggressively.
  3. Continuous Positive Airway Pressure (CPAP) treatment
  4. Mandibular advancement for patients with small lower jaw.