Pediatric Sleep Apnea

Treatment

Pediatric doctors from the Center for Sleep Medicine care for children who have sleep disorders. Other pediatric specialists from allergy; ear, nose and throat; pulmonary medicine; orthodontics; psychology and psychiatry; and craniofacial disorders provide additional expertise when necessary.

Treatment Summary

Treatments most commonly used to help children with OSA include adenotonsillectomy and positive pressure breathing. In rare instances, a child may also need to lose weight, use an oral appliance, or have craniofacial surgery. Treating nasal congestion, and sleeping on the side rather than the back, can also sometimes sufficiently treat mild OSA, or may be used in combination with other treatments to reduce moderate or severe OSA.

Specific treatment options include:

Adenenotonsillectomy (removal of the tonsils and adenoids)
Sometimes only the tonsils need to be removed (tonsillectomy) and sometimes only the adenoids (adenoidectomy).

Positive pressure breathing (also referred to as continuous positive airway pressure [CPAP])
This may be used if adenotonsillectomy doesn't help. A small electrical unit with a fan gently blows air through a tube and mask (attached to the nose or nose and mouth) into the back of the throat to keep the airway open. The level of air pressure depends on each patient's needs. Some devices lower the level for exhalation (bilevel PAP) and some automatically increase the pressure if breathing stops and lower it again when breathing is normal (auto-adjusting PAP). It's important that the device fit properly. Mayo Clinic has a specially trained nursing staff for troubleshooting problems with CPAP devices.

Losing weight
Excessive weight is a more common cause of OSA in adults than in children, but if excessive weight contributes to a child's OSA, then losing weight may be part of their treatment plan.

Oral appliance (dental device, mouthpiece, or mandibular advancement device)
The appliance moves the bottom jaw and tongue forward to keep the upper airway open. Mayo Clinic dentists have special expertise in fabricating oral appliances to treat OSA.

Septoplasty, turbinate reduction
Septoplasty straightens a deviated (crooked) septum (bony partition between the nostrils) and turbinate reduction trims or removes one or more of the curved bones along the wall of the nasal passage. Any nasal polyps are also removed. These procedures can help open the nasal passage to ease breathing during sleep.

Jaw surgery (orthognathic surgery)
In this surgery, the upper jaw, lower jaw and/or chin may be moved forward. Surgery is usually a good option for older adolescents whose jaw structure worsens blockage of the upper airway and who haven't been helped by other treatments. Mayo Clinic surgeons have significant expertise in this complex but highly effective surgery. Read more about jaw surgery.