Nasal Congestion & Obstructive Sleep Apnoea
in Children
Speaker: Haytham Kubba, Consultant Paediatric Otolaryngologist, Royal Hospital for Sick
Children, Yorkhill
Description
It is very common for toddlers to suffer from stuffy noses and snoring at night, but when should you
worry that there is something more going on? Obstructive sleep apnoea is surprisingly common in
children and it can have widespread effects on health and cognition.
Learning Outcomes
 To be aware nasal symptoms are most commonly due to adenoid hypertrophy in pre-school
children and allergic rhinitis in school-aged children: these conditions are benign and easily
managed in primary care
 To be aware a sleep history is easy and quick to take and it can be useful to identify children who
may have a significant sleep breathing disorder
 To be aware obstructive sleep apnoea (OSA) in children is most commonly due to physiological
hypertrophy of the tonsils and adenoids
 To be aware children with OSA snore and have restless, disturbed sleep
 To be aware unlike in adults, OSA in children doesn't often manifest as sleepiness but is more likely
to lead to symptoms of hyperactivity, poor behaviour, inattention and cognitive impairment.
 To be aware other features of OSA in children are bedwetting and night terrors
 To be aware endocrine disturbances occur, as well as cardiac effects including systemic and
pulmonary hypertension
 To be aware adenotonsillectomy is usually curative
Biography
Haytham Kubba has been a Consultant in Children's ENT at Glasgow's Yorkhill Hospital since 2003,
and is lead clinician for Scotland's National Service for Paediatric Airway Reconstruction
Surgery. He qualified in Newcastle and trained in Glasgow with spells as a research registrar at the
MRC Institute for Hearing Research and clinical fellow at Great Ormond Street Hospital. His clinical
interests are neurodisability, head and neck malformations and airway surgery.
Additional learning resources on subject
Guidelines
Sleep apnoea. NICE Clinical Knowledge Summaries. 2009.
http://cks.nice.org.uk/sleep-apnoea#!topicsummary
Page 1 of 2
Evidence Summaries
Obstructive sleep apnea (OSA) in children (DynaMed)
http://search.ebscohost.com/login.aspx?direct=true&AuthType=athens,cookie,ip,url,uid&db=dme&AN=360974&site=dynamed
-live&scope=site (Athens login required)
Systematic Reviews
Adenotonsillectomy for obstructive sleep apnoea in children.
Lim, J. and McKean, M.C. Cochrane Database of Systematic Reviews. 2009.
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003136.pub2/full
Treatment of obstructive sleep apnoea for chronic cough in children.
Teoh, L. et al. Cochrane Database of Systematic Reviews. 2011.
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008182.pub2/full
Article
Clinical Review: Paediatric obstructive sleep apnoea
Powell, S. (2011) GP: General Practitioner, 24th June, p.29
http://search.ebscohost.com/login.aspx?direct=true&AuthType=athens,cookie,ip,url,uid&db=heh
&AN=66429909&site=ehost-live (Athens login required)
Books
Sleep apnoea in children (GP Notebook)
http://www.gpnotebook.co.uk/simplepage.cfm?ID=1255145486
Sleep disorders in children. Pagel, J.S. In Oxford Textbook of Primary Medical Care. Jones R. et al.
2004. (Provider OVID)
http://ovidsp.ovid.com/athens/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=booktext&D=books3&AN=01189009/1st_Edition
/4&XPATH=/OVIDBOOK%5b1%5d/TXTBKBD%5b1%5d/DIVISIONA%5b2%5d/DIVISIONB%5b10%5d/CHAPTER%5b10%5d
/TBD%5b1%5d/TLV1%5b6%5d (Athens login required)
Patient Information
Sleep apnoea (NHS Inform)
http://www.nhsinform.co.uk/Health-Library/Articles/S/sleep-apnoea/introduction
Clinical Queries
Is there any evidence for normal saline drops causing rebound nasal congestion in a four week old
baby - if used frequently over several weeks to help a child breath easier? (TRIP)
http://www.tripanswers.org/answer.aspx?qid=4622
Website
The Sleep Apnoea Trust
http://www.sleep-apnoea-trust.org/
Page 2 of 2