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HealthDay Reporter

Kids who snore should beevaluated for sleep apnea.That's the main recommenda-tion that comes from a set ofupdated guidelines released bythe American Academy of Pedi-

atrics."The evidence is much

stronger today," said Dr. CaroleMarcus, a professor of pedi-atrics at the Children's Hospi-tal of Philadelphia."Pediatricians should routinelyask parents about snoring, butif they don't, parents shouldbring it up," she said. "Snoringin kids can be a sign of a seri-ous medical illness."

Marcus was referring to

sleep apnea, which is markedby pauses in breathing that

occur throughout the night anddisrupt sleep. When left un-treated, sleep apnea in childrencan result in behavioral andlearning difficulties and mayalso affect growth. These conse-quences are largely related tolack of quality sleep.

Researchers led by Marcus

reviewed studies on diagnosisand management of sleepapnea in kids published be-tween 1999 and 2011, most ofthem appearing after the lastset of guidelines were releasedin 2002. The new guidelines arepublished in the Septemberissue of Pediatrics.

If a child snores, pediatri-cians need to follow-up with athorough history and exam, shenoted. "If this all points to sleep

apnea, then get a sleep study,"Marcus said. The gold standard

for diagnosing sleep apnea is aformal sleep study, but this isnot always possible for youngchildren because it involvessleeping in a laboratory envi-ronment away from home.Other options may include ahome sleep study where chil-dren are hooked up to a moni-tor in the comfort of theirregular bedroom, or asking par-ents to videotape the child dur-ing what they believe may bean apnea episode.

Many children with sleepapnea have enlarged tonsilsand adenoids. In these kids, re-

moving tonsils and adenoidsmay cure the sleep apnea.Other treatments include posi-tive airway pressure (PAP) ma-chines to help keep the airwaysopen during sleep. Some med-ications may also help treatsleep apnea.

Dr. Michael Rothschild, thedirector of pediatric otolaryn-gology at Mount Sinai Medical

Center in New York City,agreed that kids who snoreshould be screened for sleepapnea. "If the child snores, buthas small tonsils and I get agood history from parents, andthey show no signs of strug-gling when I watch a video ofthem at night, I feel comfort-

able that this is just uncompli-cated snoring," he said. "Notevery kid who snores needssurgery."

And surgery alone doesn'tcure every kid with sleepapnea, Rothschild added. Obe-sity is on the rise among kids,and is linked to sleep apnea."There are obese kids withsmall tonsils and thin kids withbig tonsils," he said. In obesechildren, weight loss is also

part of the treatment plan assurgery alone may not resolvethe sleep apnea entirely.

The guidelines recommendweight loss in obese or over-weight children who snore, inaddition to other therapy.

More information:Get the facts about sleep

apnea from the U.S. NationalHeart, Lung, and Blood Insti-tute.

SOURCES: Michael Roth-

schild, M.D., director, pediatricotolaryngology, Mount SinaiMedical Center, New York City;Carole L. Marcus, MBBCh, pro-fessor of pediatrics, Children'sHospital of Philadelphia; Sep-tember 2012, Pediatrics

Last Updated: Aug. 28, 2012Copyright 2012 HealthDay.

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YOUR GOOD HEALTH

New guidelines issued by American Academy of Pediatrics also urgeweight loss for obese snorers

Your Good HealthEvery Week in The Chronicle-Express

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