How is OSA treated in children?

OSA is a treatable condition. Find out more about the different common treatments of OSA in children.

OSA is treatable in most children. If your child is diagnosed with OSA, there is lots of help available. Your doctor can provide some simple treatments. They will refer your child to a special sleep centre or hospital for more complex treatments.

On this page we explain these treatments for OSA in children:

• Steroid sprays and drops
• Removal of tonsils and adenoids
• Weight loss
• Breathing mask
• Mouth guard
• Tracheostomy
• Sleeping position

These are sprays or drops that your child inhales through their nose. The steroids can help to reduce inflammation (swelling) in the nose. They can help when OSA is mild or caused by allergies. Your doctor might also suggest them if other treatments have not worked. By talking through the benefits and any possible side effects, you and your doctor can decide together whether steroids are right for your child.

Young children might find drops easier to cope with than sprays.

If your child has enlarged tonsils and adenoids (small lumps of tissue at the back of the nose), these may be removed by a surgery called adenoidectomy. For many children, this procedure can improve and even cure OSA symptoms. There is a small chance of complications – ask your surgeon to explain the benefits and risks beforehand.

Your child might need to stay overnight in a sleep clinic for checks before doctors decide whether this operation would help them.

Removing the tonsils and adenoids is less likely to cure OSA in children with a small chin, large tongue or cleft palate. It might not work in obese children or those with certain other health conditions.

"Milo had an urgent operation to remove his tonsils and adenoids just after his fourth birthday. The procedure was a success and his recovery was pretty quick. Now, following the surgery, his breathing is great."

Rebecca, mum of Milo

If your child is overweight or obese, losing weight can help to control OSA. To help your child lose weight, keep them active for at least one hour a day and make sure they eat a healthy diet. If your child’s weight is caused by a medical condition, make sure this is well treated.

The NHS website has tips on how to help children lose weight. You can also ask your doctor for help.

For a small number of children with OSA, a special breathing mask can help to reduce symptoms. This is called continuous positive airway pressure (CPAP) or bi-level positive airway pressure (BiPAP).

To have CPAP or BiPAP, your child will need to wear a mask at night. This is connected to a machine that gently blows air through the mask. This air helps to keep your child’s airways open as they sleep. Wearing a CPAP mask is not painful. It can be strange at first, but most children adapt well. Read more about CPAP machines for OSA.

A specialist team will set up the machine and check how things are going.

For a small number of children with OSA, a device that holds the jaw forward can help to keep the airways open. This is worn inside the mouth at night. It fits over the teeth, like a gum shield.

The medical name for this device is a mandibular repositioning device.

Whether this device might work for your child will depend on the shape of their face.

A small number of children may benefit from a type of surgery called a tracheostomy. It’s only used for severe OSA that is caused by particular medical conditions. Even then, other treatments are usually tried first.

A tracheostomy is a breathing tube through the neck. It’s added by an operation and is left in long term. The tube sits below the throat. When your child breathes, the air flows through this tube into their lungs.

Your child’s sleeping position can affect their breathing. Some positions are better than others to keep the airway open. Sleeping on their front or side may be better than sleeping on their back.

If your child’s OSA is eased by lying on their side, simple equipment to stop them sleeping on their back might be worth trying. This is called positional therapy and includes special pillows, alarms or a belt. These encourage your child to sleep on their side. Positioning therapy has been shown to help some adults with OSA but has not been studied in children.

Babies should always be laid on their back to sleep unless you have been told otherwise by a health care professional.