For those of you who follow me on Twitter or have been subscribing to the paid reader, you may know that my daughter had a tonsil adenoidectomy because her sleep was seriously affected by her enlarged adenoids, which used to be a very disturbing and troubling problem for me. Before the surgery, every time she had a cold, she had trouble sleeping at night because she was holding her breath, and she was often so sleepy that she was easily woken up again, then she would get up and sit on the bed and cry, then fall back to sleep when she was sleepy, then wake up again, and so on until dawn. Usually when she didn’t have a cold, my wife and I used to squat in front of her bed and listen to the sound of her breathing, worrying that she didn’t take enough air when she exhaled loudly, and worrying if she had apnea when she exhaled little. Now that the surgery is almost six months old, I still often observe her sleeping, and no longer have to watch her breathing with her mouth open, instead, she breathes evenly with her lips closed, and every time she gets up at night, she habitually stands in her room to listen to her voice, but no longer hear the heavy snoring and feeble crying, instead, there is a quiet, silent night, remembering the previous feeling of heart blockage, and more and more feel the beauty of this quiet. Sometimes I think that if we were not born in today’s advanced medical world, I don’t know how long my daughter’s sleep deprivation would have lasted, and we as a family would have had to watch her face and jaw slowly deform, her teeth slowly become uneven, her physical development lagging behind and her mental cognition abnormal, but thankfully we live in today’s scientific world. The reason why OSAS is a problem that many parents struggle with is that many children’s symptoms come and go, leaving parents in a quandary, and when it’s bad, they want to get surgery immediately, but when it’s good, they are lucky that it might be okay. Looking back now, I regret that I did not operate on her earlier so that she would not have to suffer so much. I have written three paid articles about my daughter’s whole treatment experience, and I have also shared the main views of the American Academy of Pediatrics on Obstructive Sleep Apnea (OSAS) with everyone on Weibo. Recently, I saw a person who calls himself a “TCM parenting practitioner and advocate” misleading parents with the distorted theories of TCM, saying that adenoid hypertrophy should not be operated. These people, who have no medical education and little medical knowledge, are so bold as to use the omnipotent theory of yin and yang to explain it, and deny the findings of so many doctors around the world. In order to avoid more parents being misled and more children being delayed in treatment, it is better to relay the main points of the American Academy of Pediatrics on OSAS here in WeChat (click on the original article to view the original guidelines). I. All children/adolescents should be checked for snoring. Second, children and adolescents who snore or have symptoms of OSAS should have polysomnography, and if not, other alternative diagnostic tests or referral to a specialist for further evaluation can be considered. Third, adenotonsillectomy is recommended as the first-line treatment option for tonsillar adenomatous hypertrophy. IV. High-risk patients should be hospitalized for postoperative monitoring. V. Postoperative patients need to be re-evaluated for further treatment. VI. Continuous positive pressure ventilation is recommended without surgery or if OSAS is still present after surgery. Overweight or obese children should lose weight while being treated. VIII. Children with mild OSAS (sleep apnea hypoventilation index <5/hour) but with contraindications to surgery or still have mild OSAS after surgery can opt for intranasal hormones. Therefore, if your child has snoring, you should go to a quintuple surgeon for a checkup, and it is better to do sleep apnea monitoring if possible to clarify whether there is OSAS and its severity (sleep apnea monitoring needs to sleep one night, which is more labor-intensive and time-consuming, and the fee is not high, so some domestic hospitals seem to be reluctant to carry out it), and then let the ENT doctor analyze the cause of OSAS, and if If it is confirmed to be caused by tonsillar adenoid hypertrophy, the American Academy of Pediatrics believes that treatment depends mainly on surgery, and this has been the opinion in the guidelines from 2002 to 2012. In my experience, domestic pediatric otolaryngologists are far from meeting the needs of children, they have more surgeries than they can do, and their surgical indications are not too loose but too strict, so listen to them if they recommend surgery and don't count too much on medication. For intranasal hormone medications like endosonar, the opinion of the American Academy of Pediatrics is that it may improve mild OSAS, but the effect is weak and it is not clear if there will be any side effects with long-term use, and it cannot be used as the primary treatment for patients with moderate to severe disease. The effectiveness and safety of herbal medicine has never been strictly verified and should not be tried. Children with adenoids are more developed, not all children with large adenoids snore, not all children with snoring have sleep breathing disorders, and not all children with sleep breathing disorders need immediate surgery, but if your child snores, you should pay attention and seek medical attention in time, so that the specialist can evaluate and then decide on a treatment plan. Even if surgery is really necessary, it is important to properly understand the risks and benefits of any surgery. Tonsil adenoidectomy is a very mature and uncomplicated operation, and although there may be some risks, they may not be greater than the risks posed to your child by chronic oxygen deprivation and sleep deprivation. It is difficult to have the best of both worlds when a child is sick, only the lesser of two evils. Early diagnosis and early formal treatment is the best way to prevent the effects of hypoxia and sleep deprivation on a child's health.