Alex Bartle talks about obstructive sleep apnoea (OSA) in children. Alex is a GP with a masters in sleep medicine who has established New Zealand’s largest sleep clinic. Alex is a member of the Asia Pacific paediatric sleep alliance, the Australasian Sleep Association and a co-author of the NZ guidelines for sleep disordered breathing.

Obstructive Sleep Apnoea in childhood (Australasian Sleep Association)

There is some research that suggests nasal steroids may be trialled in children with mild OSA as an alternative prior to adenotonsillectomy (particularly in children with allergic rhinitis). The treatment response needs to be assessed after a six-week course with a caution that the long-term effect of treatment is unknown and monitoring for adverse effects is required. However, intranasal steroids are not recommended as the first line treatment for moderate or severe OSA.

Children who present with ADHD-like symptoms should not only be assessed for OSA but also for behavioural sleep problems which are common and are amenable to non-pharmacological treatment. Click here for ‘On the spot’ management of behavioural sleep problems in children.

New Zealand guidelines for the assessment of sleep disordered breathing in childhood (2015): Summary investigation and management of SDB in children (p46)