Obstructive sleep apnea and sleep-disordered breathing (SDB), common conditions that affect between 2% and 3% of all kids, interfere with more than just sleep. Left untreated, they can affect a child's cardiovascular health, school performance, and behavior. Children with SDB are often treated with surgery to remove the tonsils and adenoids, but in some cases, even tonsillectomy and adenoidectomy don't fix the breathing problems. Could anti-inflammatory drugs help kids with SDB sleep and breathe better?
Researchers from the University of Louisville in Kentucky studied children who'd undergone tonsillectomy and adenoidectomy for SDB. About 10 to 14 weeks after surgery, the children underwent sleep studies in a lab to check for remaining evidence of SDB. Twenty-two of the children who continued to have SDB began taking a tablet containing montelukast (a drug that blocks substances produced by cells of the immune system that cause swelling and mucus secretion) and using a nasal spray containing budesonide (a steroid that is usually used to treat symptoms of nasal allergy, like runny nose and stuffiness). After 12 weeks, the children taking the anti-inflammatory therapy underwent further sleep testing; their results were compared with those of 14 children who did not take the anti-inflammatory therapy.
After 3 months, the children who took the anti-inflammatory therapy had significantly better scores on a scale designed to measure respiratory problems, whereas the scores of children who'd received no additional treatment remained unchanged. In addition, the children and their parents didn't report any serious side effects from the tablets or nasal spray.
What This Means to You
The results of this study indicate that if surgical removal of the adenoids and tonsils does not improve a child's apnea, anti-inflammatory treatment may improve breathing and sleep quality. However, keep in mind that the study results are preliminary, and the effects of montelukast and budesonide for SDB in children need to be examined in larger trials.
Other treatments for obstructive sleep apnea include continuous positive air pressure, for which the child wears a face mask while sleeping. If your child has symptoms of obstructive sleep apnea, such as snoring, labored breathing while sleeping, gasping for air, changes in color, or very restless sleep, talk to your child's doctor.
Source: Leila Kheirandish, MD; Aviv D. Goldbart, MD; David Gozal, MD; Pediatrics, January 2006.
Reviewed by: Steven Dowshen, MD
Date reviewed: February 2006