Q: People generally think that snoring is a problem for adults, but many parents reflect that their children also have snoring, why do children snore? A: Normally there should be no snoring in the sleep state. Snoring means that there is a narrowing factor in the upper airway, from the nasal cavity to the larynx, which we call the upper airway. If there is a narrowing factor in the upper respiratory tract in children, the snoring phenomenon will occur. If a child has persistent habitual snoring and parents observe a sleep state with inspiratory effort (gasping for air), it should be considered abnormal and we call it apnea syndrome in children, which is a clear danger to the growth and health of children. Compared to adult apnea patients, apnea in children is less frequent and shorter in duration during sleep, so it is not easy to observe. Of course, if occasional snoring is caused by cold and flu, etc., it will not cause any harm to the body. Q: Is the incidence of apnea syndrome in children very low? A: The incidence rate of apnea syndrome in children is around 1% to 3%. However, the current problem is that people are not fully aware of the seriousness of the snoring problem in children. Q: Why do apnea syndromes occur in children? What is the age of its prevalence? Are there any gender differences in the onset of the disease? A: Unlike adults, children have a rapid proliferation of lymphoid tissue in the upper respiratory tract between the ages of 2 and 6 or 7, mainly enlarged tonsils and adenoids. The enlarged tonsils and adenoids block the nasopharynx and oropharynx, narrowing the patient’s upper airway and causing respiratory distress and apnea during sleep. The prevalence of apnea syndrome in children ranges from 2 to 6 or 7 years of age, with no gender differences in onset. Of course, in addition to adenoid tonsillar hypertrophy, there are other, less common causes of apnea syndrome in children. Q: What are the main manifestations of apnea syndrome in children and what harm does it do to the organism? How can parents identify whether their children are suffering from this disease? A: During nighttime sleep, the main manifestations of children with apnea syndrome are snoring, open-mouth breathing, labored breathing, abnormal thoracic movement during inhalation, observable apnea, excessive sweating, nightmares, restless sleep (sleeplessness), bedwetting, etc. The general clinical manifestations of daytime patients are nasal congestion, open-mouth breathing, fatigue, drowsiness, irritability (anxious personality), etc. Some patients have changes in facial appearance, learning, and learning. Some patients have facial changes, decreased academic performance, personality changes, etc. Those with combined sinusitis have increased nasal congestion, runny nose, etc. Those with combined catarrhal otitis media have hearing loss; severe patients have obvious chicken chest, shorter stature, etc. Apnea syndrome in children not only affects the physical development of patients, but also their intellectual development. Patients’ sleep quality is affected by the effort of breathing at night, which leads to drowsiness and weakness during the day, memory loss, and decreased academic performance; the increase of respiratory resistance leads to abnormal movement of the thorax, and over time, a chicken chest is formed; the decrease of sleep quality affects the secretion of growth hormone, and the growth and development is affected by the effort of breathing and the increase of pharyngeal secretion; the long-term open-mouth breathing leads to facial changes; because of local Because of local obstruction and decreased resistance of the body, patients are prone to combined otitis media and sinusitis. Q: If parents suspect that their child has apnea syndrome, what should they do next? A: Parents can go to a major hospital where they have the ability to see an ENT physician with experience in sleep medicine who can make a preliminary diagnosis based on history and physical examination, and further confirm the diagnosis through overnight sleep monitoring if necessary. The doctor will recommend the next step of treatment based on the child’s specific condition. Q: What kind of treatment is generally needed for children with apnea syndrome? A: Because the main cause of apnea in children is tonsillar adenoid hypertrophy, the treatment is based on tonsillar adenoid removal. Q: How is the surgery done? Does the surgery require general anesthesia? Is there any harm to the child from the anesthesia and the surgery itself? Is the surgery dangerous? A: The surgery must be performed in a large hospital with general anesthesia. The anesthesia is painless for the patient during the surgery. The excision of adenoids is performed under direct vision through nasal endoscopy, which is a minimally invasive surgery. The adenoids are surrounded by other important anatomical structures and the nasal endoscopy allows complete removal of the adenoids without damaging the surrounding normal structures. The tonsils are cut out through the mouth, and the general anesthesia ensures that the tonsils are completely cut and that intraoperative hemostasis is easy to perform. This procedure is now a very mature surgical procedure with minimal surgical damage, anesthesia and surgical risks. Q: What are the results of the surgery? A: The main cause of apnea syndrome in children is tonsillar adenoid hypertrophy, and surgical treatment is effective and generally curable. Q: The main cause of apnea syndrome in children is adenoid hypertrophy of the tonsils. I heard that the adenoids will gradually shrink after the age of 10. A: This is a misconception. If apnea syndrome in children is not treated in time, irreparable harm will be done by the age of 10. For example, the decline of academic performance, the formation of chicken chest, the harm to the cardiovascular system, psychological harm, craniofacial developmental deformities, nasal costal atrophy, etc. Q: After listening to your introduction of apnea syndrome in children, I feel that this is really a very serious health problem, is it that medical workers are basically able to diagnose and reasonably treat this disease in a timely manner? A: Even in the western developed countries, the awareness of the seriousness of apnea syndrome in children is only in recent years. Therefore, not all medical practitioners have a correct understanding of apnea syndrome in children, and it is easy to misdiagnose it clinically. Apnea syndrome in children is easily misdiagnosed as: chicken chest due to calcium deficiency, chronic rhinitis sinusitis, mental decline, idiopathic lethargy, etc.