Obstructive sleep apnea (OSA) is a disorder that results in complete or partial upper airway obstruction that disrupts normal ventilation. It occurs in two to four percent of children and can happen at any age.

Parents may report nighttime symptoms of snoring, restless sleep and pauses in breathing, as well as excessive daytime sleepiness or hyperactivity. The most common cause of OSA in children is enlarged tonsils and/or adenoids, followed by congenital malformations of the head and neck. In older children and adolescents, there are increasing numbers of OSAs related to obesity.

An overnight sleep study, also known as polysomnography, is needed to diagnose sleep disordered breathing and to quantify the severity of the disorder. Pediatricians are encouraged to refer patients who have symptoms suggestive of sleep disordered breathing to the Pulmonology Clinic for a consultation with any of the attending pulmonologists. Patients can call (800) 543-7456 to schedule an appointment at Children's Pulmonology Clinic, or they can call the offices in Encinitas, El Centro or Murrieta to schedule an appointment at one of the satellite clinics .

Dr. Meerana Lim, medical director of sleep services at Children's, has spearheaded the upgrading of Children's Sleep Laboratory. The lab has installed two state-of-theart computerized paperless sleep study units. This allows Pulmonology to conduct simultaneous studies on two patients per night when appropriate and safe. The sleep lab performs 30 to 40 studies per month.

"We are definitely seeing more referrals for sleep disordered breathing because pediatricians have been made more aware of sleep-related problems through recent guidelines published by the American Academy of Pediatrics," says Dr. Lim. "We encourage physicians to ask parents more questions related to breathing during sleep."

Dr. Lim hopes to soon be conducting research in the field of pediatric sleep as it relates to behavioral and cognitive issues, as well as studying the effect of obesity on sleep disordered breathing in adolescents.

Children's Specialists Pulmonary/Cystic Fibrosis Division