Obstructed breathing

About Obstructed Breathing (Obstructive Sleep Apnoea)

As a paediatric ENT surgeon, I often see children who snore at night or breathe noisily through their mouth while sleeping. This is very common and not all snoring is a cause for concern. Many children with mild nasal blockage, allergies or enlarged tonsils snore but still sleep well and feel rested during the day.

However, for some children, the airway becomes so obstructed during sleep that it affects the quality of their rest — a condition called obstructive sleep apnoea (OSA). These children may struggle to breathe at night, have disturbed sleep, and show signs of tiredness or poor concentration during the day. In very severe cases this can put excessive strain on the heart.

What causes obstructive sleep apnoea?

Obstructed breathing is most commonly caused by enlarged tonsils and adenoids, which narrow the child’s upper airway.

Other factors which may contribute include obesity, craniofacial abnormalities, Trisomy 21 and other neuro-muscular conditions.

Obstructed breathing and daytime symptoms

In children with sleep apnoea, the breathing pauses and disruptions during sleep can impact brain oxygen levels and reduce the depth and quality of rest. This can lead to a wide range of daytime challenges, including:

Sleepiness or irritability even after a “full night’s sleep”
Crankiness or mood swings
Poor behaviour or restlessness
Difficulty focusing or learning at school
Persistent bedwetting after the usual age

Parents commonly describe

loud snoring,
open-mouth breathing,
gasping or
restlessness during the night.
Some children may even briefly stop breathing before snorting or waking.

If you’ve noticed any of these patterns, it’s worth having your child assessed — especially if they’re struggling in the daytime.

Diagnosis

When I see your child in clinic, the first step is to talk in detail about their sleep patterns and daytime behaviours. I’ll ask about snoring, breathing pauses, restlessness and any other concerns, such as mood or bedwetting.

I carry out a gentle examination of the nose, throat and neck, looking for enlarged tonsils, adenoids, or signs of nasal congestion.
If needed, I may recommend flexible naso-endoscopy, a quick and painless test using a slim camera to look at the nasal passages and adenoids.
In most cases, a careful history and examination is enough to make a diagnosis.
If there’s still uncertainty — or if symptoms are severe — I may suggest a paediatric sleep study, which measures breathing, oxygen levels and sleep quality overnight.

Getting a clear diagnosis early allows us to plan the right support — whether that’s monitoring, medical treatment or hearing technology.

Treatments

Medical treatments can be very effective for children with mild symptoms or nasal congestion. These may include:

Steroid nasal sprays to reduce inflammation
Antihistamines for children with allergies
Nasal saline rinses to clear mucus and improve airflow

Surgical approaches

If obstructed breathing is more severe or persistent, I may recommend surgery — most commonly, Adenoidectomy and/or tonsillectomy. These procedures remove enlarged adenoids and/or tonsils that are blocking the airway. They are performed under general anaesthetic and usually take 30–45 minutes. Most children go home the same day and recover within 1-2 weeks. In many cases, this leads to dramatic improvements in sleep quality, mood and learning.

Other surgical procedures — such as turbinate reduction, tongue base reduction or septal surgery— are rarely needed in children and only considered in very complex cases.

Make an Enquiry

If your child snores, struggles to breathe at night, or seems unusually tired during the day, it could be a sign of obstructed sleep apnoea. As an experienced ENT surgeon, I can assess your child’s airway and help you understand whether treatment is needed — and what options will provide the best long-term outcome. A good night’s sleep makes a world of difference.

Click here to make an enquiry.