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When Snoring is Not Okay

"Diagnosing obstructive sleep apnea (OSAS)"
By: Ma. Jocelyn A. Niere-Quidlat, MD, FPPSWhen Snoring is Not Okay

Consult your doctor if your child’s noisy breathing or snoring becomes noticeable. A referral to the otolaryngologist (ear, nose, and throat, or ENT, doctor) may be warranted. A sleep history is important but may not be sufficient since it cannot distinguish between primary snoring, OSAS, or other causes of sleep related symptoms. Evaluation of the upper airway should also be done.

The American Academy of Pediatrics recommends that the diagnosis of OSAS be documented by polysomnography, which is done to measure several parameters on the sleeping child. This can be performed in children of any age as long as there are experienced pediatric personnel present. Polysomnography should be performed in a laboratory used to studying children because techniques and normal values are different between children and adults. 

The following parameters are evaluated during the study:

  • Brain activity
  • Electrical activity of the heart
  • Oxygen content in the blood
  • Chest abdominal wall movement
  • Muscle activity
  • Amount of air flowing through the nose and mouth

During the sleep study, the episodes of apnea and hypopnea are recorded. Apnea measures the complete obstruction while hypopnea measures the decrease in the oxygen content of the blood caused by partial airway obstruction. If there are more than 10 apnea episodes during the night or one or more episodes per hour, the test is considered significant. The combination of one or more apnea episodes and/or hypopnea occurring per hour of sleep is also considered significant. 

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