ALLERGY/PULMONARY/RESPIRATORY: Updated Guidelines for Childhood Sleep Apnoea

little girl sleepingSleep apnoea is a medical problem that can have various dangerous complications. Children are not spared from this breathing problem during sleep. This is why there are new practice guidelines for managing childhood obstructive sleep apnoea syndrome (OSAS). The recent updates are summarised here, the longer version can be found in

  • Childhood OSAS is a disorder of breathing during sleep characterised by prolonged partial upper airway obstruction and/or intermittent complete obstruction (obstructive apnoea) that disrupts normal ventilation during sleep and normal sleep patterns.

  • Symptoms include habitual snoring (often with intermittent pauses, snorts, or gasps), disturbed sleep, and daytime neurobehavioral problems with or without excessive sleepiness.

  • In addition, OSAS is associated with neurocognitive impairment, behavioural problems, failure to thrive, hypertension, cardiac dysfunction, and systemic inflammation.

  • Risk factors include adenotonsillar hypertrophy, obesity, craniofacial anomalies, and neuromuscular disorders.

  • All children and adolescents should be screened for snoring.

  • Polysomnography should be performed in children and adolescents with snoring and symptoms of OSAS; if polysomnography is not available, then alternative diagnostic tests or referral to a specialist for more extensive evaluation may be considered.

  • Adenotonsillectomy is recommended as the first-line treatment of patients with adenotonsillar hypertrophy.

  • High-risk patients should be monitored as inpatients postoperatively.

  • Patients should be re-evaluated postoperatively to determine whether further treatment is required. Objective testing should be performed in patients who are high risk or who have persistent symptoms or signs of OSAS after therapy.

  • Continuous positive airway pressure is recommended as treatment if adenotonsillectomy is not performed or if OSAS persists postoperatively.

  • Weight loss is recommended in addition to other therapy in patients who are overweight or obese.

  • Intranasal corticosteroids are an option for children with mild OSAS in whom adenotonsillectomy is contraindicated or for mild postoperative OSAS.

  • If OSAS is left untreated, important sequelae include cardiovascular, growth, cognitive, and behavioural deficits; reduced quality of life; and increased health care costs.

  • Adenotonsillectomy, the usual first-line treatment, most often cures or ameliorates the disorder.

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Image  Courtesy of Jeanne Claire Maarbes /

Somnowell Inventor - Visiting Professor Simon Ash FDS MSc MOrth BDS

Prof. Ash is the inventor of the highly successful SOMNOWELL Chrome device for snoring and sleep apnoea.

The Somnowell Chrome is made to exacting standards in the Somnowell laboratory under the supervision of Visiting Professor Simon Ash. Prof. Ash and his master technicians create each Somnowell Chrome device using their wealth of experience and expertise.

Prof. Ash works at the forefront of his profession. He is a Consultant and Specialist Orthodontist with over 30 years clinical experience, with a special interest in sleep related breathing disorders, TMJD, and bruxism. He currently works in Harley Street London and two private hospitals in London as part of a multi-disciplinary team managing snoring and sleep apnoea, and is Visiting Professor of Orthodontics at the BPP University.