QUESTION 1: Is sleep apnea seen in childhood?

ANSWER:  Yes, it is seen, children who are overweight, have developmental disorders in the facial skeleton and have tonsil-dental meatus problems are in the risk group.


QUESTION 2: What are the symptoms of sleep apnea in children?

ANSWER:  The symptoms of sleep apnea differ markedly in children compared to adults. They cause symptoms such as sleep apnea, hyperactivity in children - lack of attention, failure in class, restlessness, bedwetting at night, behavioral and learning disorders, restless sleep at night, night sweats.


QUESTION 3: Will sleep apnea harm my child?

ANSWER:  Sleep apnea takes a toll on children. Behavioral-learning disorders and hyperactivity inattention lead to significant lesson failures in these children. Academic achievement in children with sleep apnea is lower than their normal peers. Bedwetting at night, called enuresis, is an important social problem. In addition to all these, children with sleep apnea show growth-development retardation; Lack of healthy sleep is the most important cause of developmental delay. Finally, children with apnea are at risk of heart failure, hypertension, and vascular diseases.

As can be understood from all this information, the treatment of sleep apnea in children is at least as important as in adults.


QUESTION 4: I suspect my child has sleep apnea, what should I do?

ANSWER:  First of all, an ear, nose and throat examination should be done. The adenoids should be evaluated with endoscopic examination, and the size of the tonsils (tonsils) should be reviewed. If possible, the root of the tongue and larynx should also be examined in the endoscopic examination. If there is a suspicion of a developmental disorder in the facial skeletal structure, orthodontic examination should be performed, and the skeletal structure of the lower and upper jaws should be examined.

It is difficult to perform a sleep test in children, but if the physician evaluating the child wants to confirm the diagnosis, the adult sleep test can also be applied to children. It makes a significant contribution to the diagnosis in simpler methods than the sleep test; Recording the oxygen level during sleep and video recording of the child during respiratory events helps the physician.


QUESTION 5: How is sleep apnea treated in children?

ANSWER:  Treatment is cause-oriented, weight loss if the child is overweight; If there are lower and/or upper jaw skeletal disorders, orthodontic treatment or skeletal surgery is applied. Sleep apnea in children is mostly related to adenotonsillar hypertrophy, namely adenoid and tonsil sizes. Removal of adenoid, removal or reduction of tonsils is the first treatment to be applied. In a small number of children whose complaints and apnea continue after adenoid-tonsil surgery, tongue root surgeries may come to the fore.

If children with overweight and lower and upper jaw skeletal disorders have adenoid-tonsillar enlargement at the same time, treatment is started with adenoid-tonsillar surgery.

There is no debate about the complete removal of the adenoid in a child with sleep apnea, and successful results are obtained by reducing the tonsils instead of removing them completely.


QUESTION 6: Will removing the tonsils harm my child?

ANSWER: There is no difference between children with and without tonsils. After the tonsil is removed, there is a temporary effect on the immune system for 3-4 months that will not affect the health of the child. In the long run, the immune system returns to normal. Removal of the tonsil does not create a predisposition to other diseases that may occur in the child. Partial removal or reduction of tonsils, which has been applied more frequently in recent years, can be preferred especially in children who have been operated for sleep apnea.


QUESTION 7: Is it true that adenoids get smaller with advancing age?

ANSWER:  The adenoid becomes noticeably smaller after the age of 12-13, but the purpose of adenoid and tonsil surgeries is to prevent the damage caused by sleep apnea in children. When it is expected until the age of 12-13, it is highly likely that there will be growth-development retardation, development of heart diseases, and developmental problems in the facial skeleton. In addition, behavioral disorders and course failures can cause significant social problems in the child. If adenoid and tonsil size is diagnosed and associated with sleep apnea, surgical treatment should not be waited for a long time.


QUESTION 8: I had my child's adenoid and tonsil removed, but snoring and apnea complaints continue; what should I do?

ANSWER:  If the complaints persist after adenoid and tonsil surgery, the otolaryngologist should reevaluate the child. Insufficient removal of the adenoids and insufficient reduction of the tonsils if the tonsils are partially removed may lead to the continuation of the complaints. Extremely large root of the tongue, loose structure of the pharynx and closure of the airway can be seen, albeit rarely.

When no tissue obstructing the airway is observed, orthodontic measurements are required by the dentist to evaluate the tooth and jaw structure and orthodontic treatment is required if necessary. A number of exercises that strengthen the mouth and tongue muscles are also very useful.

If sleep apnea continues despite all this, the use of devices that continuously pressurize the airway, called PAP, comes to the fore.


QUESTION 9: Why are tonsil surgeries performed other than sleep apnea or snoring?

ANSWER:  Today, apnea and snoring are the most common reasons for tonsil surgeries.Frequent tonsillitis, chronic infection in the tonsils, protecting children from infections with high fever in some cases, suspicion of a tumoral disease in the tonsils are the first reasons for tonsil surgery.