Dr. Stephen Schendel
Plastic, Maxillofacial and Sleep Surgery

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OSA - Children

Obstructive Sleep Apnea (OSA) in Children - Palo Alto, CA


Obstruction of the airway during sleep may be much more subtle in a child. Although the term sleep apnea may still be used, true apnea commonly does not occur. Instead, the obstruction will lead to a disruption of sleep. Snoring is a sign that disruption is occurring. Reoccurrence of these events throughout the night prevents the child from obtaining a restful sleep.

Some signs associated with OSA in children are:

  • Irritability
  • Poor attention span
  • Poor physical growth
  • Lack of concentration
  • Pulmonary and cardiac side effects

Recent reports in the pediatric literature have stressed that because signs of this process are perhaps less obvious in children, any child with snoring deserves evaluation. This evaluation will include a thorough examination of the upper airway and a detailed history of the child’s social and intellectual development. A sleep study may then be used to confirm the diagnosis and establish the real severity of the problem.


Radiofrequency is a non-surgical method that uses a small electrode to shrink the turbinate without damaging its function. A CPAP machine may also be utilized as a non-invasive treatment. This may be difficult for the pediatric patient to tolerate.

Surgical treatment is aimed at eliminating the obstruction. The tonsils and adenoids are addressed first and should be evaluated based on their size relative to the individual patient’s airway. As shown below, suturing techniques are used to further increase the size of the airway after tonsillectomy.

In addition, the interior of the nose should be examined. Inflammation of normal structures known as turbinates can contribute to the obstruction. Tonsillectomy with adenoidectomy is very effective. Radiofrequency can also be used to reduce the turbinates. It is important to document whether or not the sleep issues have been completely resolved after any procedure. In some cases, jaw surgery may also be necessary. If you have questions about your child’s sleep health please contact our center through the website, or call us at (650) 353-7352.