Sleep Apnea – A New Treatment Option For Children


Sleep apnea is estimated to affect some two to three percent of children today (getting on for two million children in the United States alone) and is particularly seen in children between the ages of about three and six.

In the vast majority of cases the main cause of sleep apnea, in this case obstructive sleep apnea, is enlarged tonsils and/or adenoids and the preferred method of treatment is surgery.  However, research being carried out at the University of Louisville in Kentucky may well result in thousands of children escaping what is for many an unpleasant and often frightening procedure.

Although the removal of tonsils and/or adenoids in children was extremely common some years ago the practice was, until recently, in decline, as doctors sought out alternative treatments for childhood throat infections.  However, as an increasing number of children were diagnosed with sleep apnea, tonsillectomy and/or adenoidectomy rapidly became a common treatment for this condition and today some estimates show that as many as ninety percent of all such operations are carried out to cure sleep apnea, rather than throat infections.

It seems, however, that this could well change in the not too distant future.

Dr Goldbart, heading a research team at the University of Louisville, has been working in this area for some time now and presented the initial findings of his work on the tonsillar tissue of children with sleep apnea in June 2004.  Based on these findings, Dr Goldbart’s team proposed an alternative non-invasive treatment for mild cases of childhood sleep apnea and has since carried out a series of studies, the latest of which involved 40 children.  The results have now just been published and are extremely encouraging.

The treatment involves the use of oral montelkast (sold under the brand name of Singulair) which many parents may well recognize as a common form of treatment for asthma.

In many cases of asthma breathing difficulties are caused by inflammation of the tonsils resulting from the presence of leukotriene receptors and Dr Goldbart and his team noticed that these same leukotriene receptors were present in the tonsils of children with sleep apnea.  He concluded therefore that the treatment that has proved so effective in cases of asthma should also reduce inflammation and open up the airway in cases of sleep apnea, and it would appear that he is right.

It is of course still early days and a great deal more work needs to be done, including further double-blind and placebo-controlled studies.  Nonetheless, his findings are indeed encouraging and may well provide an alternative to surgery for many thousands of children in the future.

By Donald Saunders –

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