Ear Tubes, Snoring & Sleep Apnea in Children

A recent study examined the risk of sleep-disordered breathing in children who had ear tubes inserted.

The study from Israel involved 352 children with ear tubes. Another 105 children were included as controls. Parents were interviewed by phone.

Results show that sleep-disordered breathing was common in children who had ear tubes inserted. Twenty-two percent of parents reported that their child snores.

Tonsils had been removed from 18 percent of children with ear tubes. This surgery is a common treatment for obstructive sleep apnea in children. Thirty-four percent of children snored or had their tonsils removed after the ear tubes were inserted.

Children with ear tubes were four times more likely than controls to have future tonsil removal. Their risk for snoring was three times higher.

The authors reported that sleep-disordered breathing shares common mechanisms with Eustachian tube dysfunction. This tube extends from the middle ear to the throat.

They concluded that children who need ear tubes inserted are at risk for sleep-disordered breathing. Doctors should regularly check these children for symptoms of sleep apnea. This will allow for early detection and treatment.

MedlinePlus reports that ear tube insertion helps relieve fluid buildup behind a child’s eardrum. The tubes allow the fluid to drain so that the ears can function normally. Another name for the procedure is “tympanostomy tube insertion.”

It may be recommended when excess fluid in the ear does not go away after four months or longer. Tubes also may be inserted if an ear infection does not go away or if a child has many ear infections.

The AASM reports that about two percent of healthy young children have OSA. It occurs when soft tissue in the back of the throat collapses and blocks the airway during sleep.

Most children with OSA have a history of loud snoring. This may include obvious pauses in breathing and gasps for breath. Parents often notice that the child seems to be working hard to breathe during sleep.

Read more about obstructive sleep apnea in children. Get help at an AASM-accredited sleep center near you.

Image by Travis Isaacs

Use of Codeine in Children After a Tonsillectomy Can Be Fatal

According to a new case report, the use of codeine for pain after tonsillectomies can be deadly in children who have a rare gene that causes the body to metabolize the drug at a faster rate than usual.

The gene is found in about one percent of white people, but could be present in as many as 30 percent of people of African origins, notes U.S. News & World Report.

The report was released after the death of a two-year old boy with the gene, who was given codeine after having his tonsils removed.

The child, who had a history of snoring and sleep-study confirmed sleep apnea, underwent a tonsillectomy at an outpatient clinic and was taken home. He died two days after the surgery when his body produced more than twice the normal level of morphine.

Prescribing codeine for children who have tonsillectomies to cure sleep apnea can be dangerous if the surgery does not cure the disorder, as the drug can suppress breathing.

Researchers involved in the study said that the tragedy shows the importance of keeping children in the hospital for observation for at least 24 hours after the surgery to ensure that the sleep apnea is gone.

According to the AASM, obstructive sleep apnea (OSA) is a sleep related breathing disorder that is seen in about two percent of young children. It can develop in children at any age, but it is most common in preschoolers. OSA often occurs between the ages of 3 and 6 years when the tonsils and adenoids are large compared to the throat.

Learn more about childhood sleep apnea on SleepEducation.com.