Sleep Apnea in Singapore

Although snoring during sleep sounds like a norm, it could actually be due to sleep apnea, a potentially serious sleep disorder. In fact, it has been estimated that about 15% of Singapore’s population is affected by sleep apnea and this condition can affect one’s quality of life and may even result in other health conditions such as high blood pressure and heart problems. Loud snoring and feeling tired after a full night’s sleep are all common symptoms of sleep apnea to look out for, but other symptoms also include insomnia, irritability and gasping for air during sleep. It is also important to note that it is not just adults who are at risk of sleep apnea; snoring in children is common too and may be due to paediatric obstructive sleep apnea.

Snoring in Children

Snoring in children is also a sign of sleep apnea, a common condition in Singapore. This is a sleep disorder in which your child’s breathing gets partially or completely blocked due to the narrowing of the upper airway during sleep. Paediatric obstructive sleep apnea and adult sleep apnea have their differences – adults tend to experience daytime sleepiness while children exhibit behavioural issues. Hence, early diagnosis and treatment at an ENT clinic in Singapore is recommended to prevent letting sleep apnea from affecting your child’s growth, cognitive development and behaviour which can all have lifelong effects. Make a doctor’s appointment as soon as possible if you notice your child waking up in the morning feeling tired constantly  or has been exhibiting behavioural problems.

Causes

One of the most common causes of sleep apnea is obesity as fat deposits in the upper respiratory tract narrow the airway, resulting in a decrease in muscle activity in this region and ultimately leading to sleep apnea. Apart from obesity, other underlying factors like craniofacial anomalies (deformities that affect a child’s head and facial bones) and neuromuscular disorders (conditions that impair the functioning of the muscles) can play a role too. Enlarged tonsils and adenoids that obstruct the airway are one of the most common causes. It can be difficult for parents to pinpoint the exact cause of their child’s sleep apnea so it is advisable to visit an ENT specialist in Singapore to figure it out so as to administer the appropriate treatment.

Risk Factors

Besides obesity, other risk factors that can result in snoring in children that may ultimately lead to sleep apnea include: down syndrome, abnormalities in the skull or face, cerebral palsy, sickle cell disease, neuromuscular disease, history of low birth weight, and a family history of sleep apnea. Hence, if your child falls into any of these categories, it is important to pay extra attention to detect symptoms of sleep apnea early so you can bring him or her to the ENT specialist for treatment. Early treatment can drastically improve your child’s quality of sleep and prevent potential health problems that may arise in the future.

Symptoms

Symptoms of paediatric obstructive sleep apnea include frequent tossing and turning, snoring, pauses in breathing, restless sleep, snorting, coughing, choking, mouth breathing, nighttime sweating, bed-wetting, and sleep terror – these can happen during sleep. Other symptoms that may present themselves in the day include performing poorly in school, having difficulty paying attention, having learning problems, having behavioural issues, hyperactivity, and poor weight gain. Look out for these symptoms and bring your child to an ENT clinic in Singapore to get them checked as soon as possible if you suspect your child is suffering from sleep apnea. Early diagnosis and treatment is to prevent complications that may arise as a result of late treatment of sleep apnea.

Complications

Since sleep is essential for the body to recuperate and re-energise, having interrupted sleep caused by sleep apnea can have long term detrimental effects on your child’s mental and physical health. If the condition is left untreated, paediatric obstructive sleep apnea can cause serious complications such as failure to grow and thrive, attention-deficit disorder, behavioural problems, poor academic performance, heart problems and even death. Although most children have mild symptoms and may outgrow the condition, it is still advisable to seek treatment at an ENT clinic in Singapore for prompt medical attention.

Diagnosis

It is recommended that you bring your child to an ENT specialist for an accurate diagnosis where a physical examination of the nose, mouth and throat may reveal the source of the obstruction. The doctor may also order some tests to diagnose the condition accurately. They include polysomnogram; an overnight sleep study that records brain wave activity, breathing patterns, snoring, oxygen levels, heart rate and muscle activity while your child sleeps, oximetry; an overnight recording of oxygen levels, and electrocardiogram; to measure the electrical impulses given off by your child’s heart to check for an underlying heart condition. The exact test will be recommended by the doctor based on your child’s condition and symptoms.

Snoring Treatment in Singapore

Snoring treatment in Singapore for paediatric obstructive sleep apnea includes treating the areas of obstruction. This may include medications for blocked nose and allergies to ease symptoms, removal of the tonsils and adenoids to prevent obstruction of the upper airway, positive airway pressure therapy to send air pressure into the back of your child’s throat to keep the airway open, and wearing oral appliances to expand the palate and nasal passages or move your child’s bottom jaw and tongue forward to keep the upper airway open. Apart from these, other lifestyle changes and home remedies may help too, such as losing weight if obesity is the cause and avoiding airway irritants and allergens that can cause congestion.

What is snoring?

Snoring is the noise caused by the vibration of the soft tissues of the mouth, mainly the uvula and the soft palate. How loud the snoring is, depends on the amount of air, the vibration and the degree of collapse of the soft tissue.

Is snoring normal?

Snoring may be an indicator for sleep disordered breathing which encompasses Obstruction Sleep Apnea. According to American Academy of Pediatrics (AAP), 1.2-5.7% of children are affected by OSA.

Should I be concerned?

Sleep is essential to restore the body and if a child has sleep disordered breathing, it can cause restless and interrupted sleep.

What are the other symptoms of sleep disordered breathing?

Other symptoms can include

  • Labored or obstructed breathing patterns during child’s sleep (choking during sleep)
  • Restless sleep and frequent tossing and turning at night 
  • Sleepiness during the daytime
  • Unrefreshed sleep 
  • Hyperactivity 
  • Behavioral issues such as poor attention and impulsive behaviors 
  • Poor growth

What do I do if I think my child may have sleep disordered breathing?

Child should be carefully accessed by an ENT specialist. An examination of the nose, mouth and throat may reveal the source of the obstruction.

Risk factors such as obesity, other craniofacial abnormalities, blocked nose should be identified and if possible, treated.

If the child has enlarged tonsils and adenoids, an adenotonsillectomy may be considered as a first line of treatment.

Based on the clinical findings, your child may need a sleep study to evaluate for sleep apnea.

Is there a treatment for snoring?

The underlying cause of snoring needs to be identified. Sometimes, medical treatment may suffice if the cause is just blocked nose and allergies.

If obesity is an issue, the child should be encouraged to lose weight. You can work with your pediatrician on this aspect. Other causes such as tonsil and adenoid enlargement may require surgery.