I'm very new to all of this, so please excuse my ignorance.  My 4 year old daughter was just diagnosed with what I thought was OSA.  We were told to bring her to an ENT to have her tonsils and adenoids checked.  I brought her to an ENT (who I disliked) and he told me that her tonsils and adenoids were at a 3 1/2+ and that they should definitely be removed.  I decided since I wasn't completely comfortable with him that I would take my daughter for a 2nd opinion.  The 2nd ENT looked at her tonsils and said that they were at a 2 1/2 and that surgery isn't necessary.  He then told me that it doesn't actually look like she has OSA, it looks like she might have Central Sleep Apnea, with a bit of behavioral problems.  I am extremely confused and really not sure where I should go from here.  Any advice would be greatly appreciated.

We just got finished with a sleep apnea study on my 9 year old daughter.  She was tested by a Pediatric Sleep Neurologist.  She does have apnea, as do my husband and I.  Her problem is the fact that she has very little room in the back of her mouth for airflow.  I am the same way. Sleep Apnea is heriditary The Dr. said that the first thing that she would have recommended was tonsils/adenoids, but my daughter had hers removed at 15 months-- had nothing to do with apnea.

We got to the sleep study after my daughter was unsuccessfully treated for 6 years for ADHD. Her Dr. and I racked our brains and I mentioned to him that she is so restless, has dark circles under her eyes, is constantly up in the p.m., ect. and he said that this is the most common overlooked problem in children with ADHD, etc.  She was also diagnosed with PDD-NOS, a form of Autism by another Dr.  

Her referring Dr. said that her frontal cortex has completely shut down due to the fact that she is SO sleep deprived.  She cannot make rational decisions and has no coping skills.  She cannot focus and is all over the place.  When this apnea is corrected, she will improve AT LEAST 30 to 40 percent with the PDD-NOS, possibly more.

I know this isnt what you were originally asking, but I am sharing this because other parents will be reading this and parents are the ones who spend all of the time with their kids.  My daughter has the best Dr. who has been treating her for all of these years and we got to get her CPAP tomorrow.  

I know the thought of surgery is scary.  It certainly was on a 15 month old, but our daughter was battling chronic strep, tonsilitis, etc.  At this point, I look at the big picture and pray that the CPAP will be an answer to our prayers because the last 6 years have been a nightmare......

I wish you the best of luck in your decisions. I hope this helps!

Has she had a formal sleep study? That is the only way to diagnosis a specific form of apnea, whether it's obstructive or central or mixed.  I would highly recommend starting with that. If she is diagnosed with central apnea, then I'd recommend finding a neurologist that specializes in pediatric sleep disorders and a pulmonologist that specializes in pediatric sleep disorders if she has obstructive. If she has mixed apnea, then I'd shoot for the neurologist, but this is because we've had horrible luck with our pulmos and have adored both our neurologists.

Ask lots of questions...Keep asking until you get answers you understand and feel comfortable with the plan of action to take place..

Tiffany Acuff..Mom to Isaac, who just slept his first night with c-pap for 2 hours at just 3 years old!!! and to Esther Rose, who sleeps like she was born to do nothing else!

My daughter who has OSA was checked out by an ENT originally and told that she couldn't have OSA by his opinion. After a sleep study we found she has both OSA and CSA. Definitly get a sleep study and read the results yourself. Then ask all the questions you need to understand. In my experience with all of my daughter's specialists they are too pushy about surgery. And they have actually told me they push it to cover their backsides. Just do what you feel is right :)