Sleep is vital for childhood development, so it’s no surprise that many parents are concerned if their child snores. If the snoring only happens occasionally, there is no need to worry. But if it is frequent or severe, then it may mean that your child has obstructive sleep apnoea. The effects of this on a child can include disturbed sleep, poor daytime behaviour and difficulty learning at school. So if you are worried about your child's snoring, you should make an appointment to see an ENT specialist as soon as possible.
What is obstructive sleep apnoea?
Obstructive sleep apnoea (OSA) is when a child briefly stops breathing while sleeping. It happens because of a blockage in the upper airway. The pause in breathing may occur many times in a night, disrupting the child’s sleep. The condition is most commonly found in children ages 3 to 6.
What are the symptoms of OSA in kids?
During sleep, you might notice the following:
So why does OSA in children matter?
Over time, sleep apnoea can have significant effects on your child. Fatigue can lead to poor concentration and the inability to function during the day. This leads to poor school performance. It can also cause hyperactivity and mood swings.
Due to reduced oxygen intake through the night, children can experience growth or developmental delays in severe cases. Paediatric sleep apnoea is also associated with heart problems, high blood pressure and childhood obesity, and can have an impact on brain function and intelligence.
What is the treatment of paediatric obstructive sleep apnoea?
Treatment will depend on your child’s symptoms, age, and general health. An overnight sleep study is often conducted to find out how severe the condition is.
The treatment for OSA is based on the cause. It may include:
Sneezing and a runny nose are annoying symptoms of the common cold. But when you have pain and pressure, there is a good chance you have a sinus infection. When your sinuses are blocked, pressure builds up inside them. This can make your face sensitive to touch, especially around your nose and eyes. You might notice that leaning forward or moving your head causes the pain and pressure to worsen. If this happens, it is time to see your friendly Singapore ENT doctor and sinus specialist!
What are the symptoms of sinusitis?
How long does a sinus infection last?
There are two main types of sinus infections, acute and chronic.
Acute sinus infections come on suddenly. They can be caused by a virus or bacteria. An acute sinus infection caused by a virus is the most common type of a sinus infection, and it typically clears up on its own. It can take up to four weeks to recover completely, but your symptoms will begin to clear up after about seven days.
An acute sinus infection caused by bacteria lingers longer and will likely need medical treatment to heal. Symptoms of a bacterial sinus infection can last for ten days or more, but go away quickly once you get treatment.
A chronic sinus infection is an infection that lasts long-term, usually for 12 weeks or longer. They can be caused by bacterial infections that aren’t treated or fungal infections. Chronic sinus infections are more complicated to treat, and they won’t go away on their own.
Tips to avoid sinus infections
We've all had that feeling of blocked ears on a flight. Usually it will clear easily by blowing the nose or swallowing. But what happens if it doesn't clear? This is when you should see an ENT doctor to try and relieve the blockage. Persistent ear block can lead to pain or even hearing loss. The following article explains a little more about the what might be causing the problem and how best to treat it.
What is the Eustachian tube?
The Eustachian tube is a cartilaginous and bony tube providing a connection between the back of the nose (nasopharynx) and the middle ear. At rest, the Eustachian tube is closed, but it opens when you swallow, yawn or sneeze. It can also be opened forcefully by raising pressure in your nasopharynx by blowing your nose and “popping” your ears. When the Eustachian tube opens, it allows the equalising of pressure between the external environment and the middle ear by allowing a small amount of air to pass through.
What are the symptoms of Eustachian tube dysfunction?
When the Eustachian tube does not work very well, a number of different symptoms can occur. These include:
Feeling of fullness in the ear
Ringing in the ears (tinnitus)
Dizziness or balance problems
What causes Eustachian tube dysfunction?
The main causes of Eustachian tube dysfunction are conditions that lead to swelling in the nose and nasopharynx. These include upper respiratory tract infections, allergy, pollution, and smoking. Other triggers include extreme pressure changes that occur when flying or SCUBA diving, and temporomandibular joint (TMJ) disorders.
How is Eustachian tube dysfunction treated?
Firstly, it is important to see an ENT doctor to exclude other common causes which often produce similar symptoms (e.g. impacted ear wax, outer or middle ear infection, sudden sensorineural hearing loss, or ear drum perforation).
Once these other causes have been excluded, the ENT specialist will usually try medication to reduce the swelling which is the causing the blockage of the Eustachian tube. These include nasal decongestants (e.g. Afrin, Iliadin), topical nasal steroid sprays (e.g. Avamys, Nasonex) and antihistamines with decongestants (e.g. Telfast-D, Zyrtec-D).
If the medication doesn’t work, then the patient can consider a procedure in order to relive the symptoms. A small cut in the ear drum can be done under local anaesthetic (myringotomy). If this helps, then a small tube (grommet) can be inserted to keep the hole open. This has several disadvantages, however. In Singapore (because of the humidity), the risk of an ear infection is high – this is more likely if the patient swims regularly. It also cannot be used if the patient is a SCUBA diver.
A promising new treatment – first described in 2011 and only available in Singapore in the last 6 years - is to use a high-pressure balloon to widen the cartilaginous Eustachian tube. Known as Balloon Dilation of the Eustachian tube or Balloon Eustachian Tuboplasty, this simple procedure restores normal tube function and can reduce or resolve the patient’s symptoms. It is usually performed under a short general anaesthetic in day surgery; however, it is increasingly being offered under local anaesthetic. During the operation, a probe is inserted into the affected Eustachian tube and a special balloon is inflated to a set diameter at high pressure (10 bar). You can see a video of the procedure here. Complications from the procedure are rare and the recovery is very quick.
If you see an ENT doctor in Singapore with a blocked nose or sinus infection, he or she will often consider allergy as an underlying risk factor. The commonest allergy in Singapore is house dust mite allergy. About 80% of the adult population in Singapore has evidence of house dust mite allergy (IgE antibodies) but only half (roughly 40%) will develop symptoms of allergic rhinitis (swelling of the nasal lining).
Avoiding exposure to dust mites is the best strategy for controlling dust mite allergy. While you can't completely eliminate dust mites from your home, you can significantly reduce their number.
This ten-point plan will help reduce dust mites in your home.
Welcome to Dr Chris' blog page
In this blog, Singapore ENT Specialist and Head & Neck Surgeon, Dr. Chris Hobbs, will share useful information about the ENT conditions that you may be suffering from.