Hello,

I am brand new to the forum but discovered this website a few nights ago during a desperate attempt to learn about pediatric sleep apnea. I have a darling little 3-year-old daughter who started snoring almost two months ago to the date. In fact, I remember the day she began snoring (and so does my husband) because it took us by surprise -- we were on a cruise and in port in Cozumel that day and I figured she was simply exausted from our day at the beach.

We honestly didn't think much of it until a full week passed and her snoring was a daily/nightly event and worsening. She is audible from across the house! We mentioned this to her pediatrician at her 36 month well-check in September and she recommended we keep an eye on her for 30 days and if her snoring didn't subside, Madi would be referred to a pediatric ENT. FWIW, her pediatrician noted on three prior occasions that Madi's tonsils were "a little large".

Fast forward to the beginning of November and her snoring had not improved in the least bit so I called her pediatrician. That's when the referral to the pediatric ENT was made. She will see him tomorrow morning, bright and early. What a relief, although I'm a bit anxious.

I try to observe her for a little while each night and have noticed the following: she always snores while she sleeps, she almost always sleeps with her mouth open, she frequently repositions herself throughout the night (she tends to sleep comfortably with her upper body elevated, or she'll curl up on her side in a "C" position), she will rapidly "belly breathe" where her stomach rises and falls more prominently as opposed to her chest rising and falling, followed by short pauses in breathing (none longer than 5 or 6 seconds from what I've observed), and she sometimes makes a snorting sound (hard to describe, it's not a choking or gasp by any means but it's definitely a little spurt of noise, kind of like an oink). The lack of her pausing for extended lengths of time is what makes me question whether or not this is apnea, although much of what I've read points to a possibility of it.

I guess I'm starting to ramble here...if anything, it's relieving to type everything out and clear my mind. From what I'm describing, do you have any thoughts? My husband did record her snoring for approx. 30 seconds the other night and I'm currently in the process of trying to upload it to a place online where I can share it when allowed (per the TOS) as well as bring it with me tomorrow to show the ENT.

Hope this wasn't too long! I look forward to hearing from anyone who is willing to chime in. I appreciate your time!

Well, my guess is that, when you speak with the ENT, and if an exam reveals enlarged tonsils and/or adenoids, they will recommend a T&A without a sleep study, and if that resolves her snoring and other symptoms of obstructive sleep apnea, it will be presumed cured by the surgery. If, after your appointment, you are concerned, confused or needing additional input, by all means come on back and lay it all out here and we'll try to help you out with anything we can!

In preparation for the appointment, you may want to formulate some questions you may have regarding a recommendation for surgery so that you are prepared to get some answers right away if it comes up (it can be really hard to leave an appointment and then realize that you have a hundred questions which didn't come to mind because you were not expecting the the recommendations...). If a sleep study is recommended as a next course of action, I suggest jumping on it -- not only would it give you a baseline look at her sleep, for comparison after surgery (if that's what is recommended), they provide enormous amounts of information about an individual's sleep that is otherwise unavailable, and it is also a relatively non-invasive procedure which can be a helpful precursor to a hospital visit for surgery for a child who doesn't have a history of medical interventions.

Good luck, and let us know how it goes.

Thank you, Lorenzomama, for your helpful reply! I will definitely come back today after Madi's appointment and update everyone. I have to say, I haven't slept well all night and I've been up since 6:30AM just tossing and turning. This is Madi's first venture with a specialist of any kind and I'm not quite sure why I'm taking it so hard.

You mentioned a sleep study and I'd definitely prefer to have one done before the T&A if that's what the ENT recommends for treatment. I'm going to use this time to gather my thoughts and put my questions on paper. I'll be back later this morning. Thanks again!

Alright, I'm back with an update...

First and foremost, I absolutely love Madi's ENT and I'm happy to say, Madi didn't complain much. He is well-known in our community and most definitely lived up to his reputation this morning. After some questions and a brief exam, he supports my suspicion of OSAS and found that her tonsils are definitely enlarged. He ordered a sleep study and pending those results, we will discuss a plan of action which includes the possibility of a T&A.

Now, we wait to hear from Children's Sleep Lab for our appointment. Thanks for the support -- I will keep reading the forum and will continue to update when more information comes about. This is a lovely community and I'm happy to have found you!

Wow, I am so glad you have such a good ENT! That's awesome that he wants a sleep study done prior to a T&A -- an excellent sign of competence, in my opinion. I don't know how long the wait will be for you for a sleep study, but during that time, it can be helpful to start doing some things to prepare Madi. When you schedule the appointment, find out if it's okay with them for you to bring her there a few times just to check the place out -- just a walk in and out and around at first, then maybe a look into the space where her actual study will take place, and maybe even a look at the equipment, letting her take the lead on how much she is ready for. The other thing you can do is start to practice the notion of sleeping with stuff attached to her body. Some of us have short lengths of yarn and band-aids or bandaging tape to get our kids accustomed to the many leads that have to be attached for a sleep study. If you like, I can PM you a couple of links to some video of a child's sleep study so you can see for yourself what you can expect in terms of the process of attaching leads and monitors, etc.

And there is a very simple explanation for why you are taking Madi's first foray into medical intervention so hard -- you are her mama, and you have an instinctive need to protect her. In situation like this, even though you know intellectually that interventions, even potentially painful ones, may help her in the long run, neurologically you are reacting to short term need to protect your child. In other words, you are doing what eons of mothers have done, and exactly what you are supposed to do -- feel that urge to protect her, and yet balance that with your more conscious awareness of the long term situation. Give yourself a hug, take a deep breath and let yourself honor whatever feelings arise -- you are doing a great job......

Lorenzomama, your posts have comforted me in ways you cannot imagine! I was very pleased to read your latest reply to my post because it contained much of what I had running through my mind already (RE: using the time before the study to prepare).

This afternoon, I received a phone call from the sleep center, and although they have openings this weekend I opted to go with November 25th as my husband will be able to join us on that date. At first, the woman told me only one parent can attend and she made it seem as though it was a hard and fast rule -- no ifs, ands, or buts about it. She bent the rule once I explained that we run a very close household and if this is going to work, we will both be there, as Madi has never been away from either of us for a full night. Come to find out, due to them only having two twin beds in the room, that is where the rule came from. I got the whole,"Where will he sleep?" guilt trip but given the fact that my husband works the third shift, he doesn't plan on sleeping much and will most likely curl up in a corner. I work in the medical field and I promised her we are not trying to interfere or push our weight in any way...I just know my little girl.

You brought up some excellent ideas for preparing Madi and I will absolutely try them out! In fact, I'm going to involve her with the entire process by bringing her with me to the store to pick out some yarn and tape so we can play around with "attaching leads". Bringing her to the facility is a fantastic idea and I am going to call them tomorrow to see if I can bring her by Thursday for a quick look around. Also, do you mind PMing the videos to me? They would be extremely helpful to us. Do you recommend I show any to Madi? I'm not trying to talk her up by any means but she is a very intelligent little girl who works well when things are explained to her. She is more apt to accept something if we talk about it and give her examples. For example, she was very nervous about seeing the ENT this morning but when I told her that I saw one a few months ago, and that her Uncle Chris saw one last week, she was more at ease. I can always see the wheels turning as things are explained to her. LOL!

She's currently curled up next to me napping. She's snoring away with her mouth open and I've observed her for about an hour now. I've noticed that she will have complete breaths with her chest rising and falling properly, then she'll take some abdominal breaths that are slower and more shallow, and then she'll pause. When she breathes again the noise that accompanies it sounds like she's snoring only louder. I'm definitely interested to see what the sleep study says.

Thanks again!

Good for you for being such an ardent advocate for your daughter -- she's very lucky to have you. I'll PM you the links -- I'd suggest that you watch them yourself first and then decide if you think they'd be helpful for Madi. You know her better than anyone, and you will know if she would benefit from seeing them, or not.

I also wanted to add that using the play therapy model for preparation can be helpful, too -- using dolls and/or stuffed animals to role play the experience in advance. I also found it helpful to have a list of things to bring with us for sleep studies -- water and snacks for all of us, books to read, a familiar toy from home, something new and exciting for distraction, usual pillow from home (or at least pillow case), shampoo (there's usually a lot of goo in the hair after the leads are removed), and an extra pair of pajamas (just in case). Be prepared to get very little sleep (ie, nap that day yourself if you can -- though they usually recommend that you avoid letting the child nap in order to assure that they are really tired when it comes time for the study -- or have plan to allow for that the next day), and be aware that most labs end studies after a set amount of time, not necessarily when your child wakes up in the morning.

Every child is unique, so it's really important to just follow your intuition about your specific child in terms of preparation and during the study itself.

Me again, popping in to let you know that I had to take a few days off from reading the forum and chatting about Madi's impending sleep study because my worry grew out of hand!

Friday afternoon I found a lump under Madi's arm, right next to her armpit. I immediately panicked, thinking the worst of the worst (my job in the medical field is sometimes a bad thing because I "know too much" and tend to immediately think of the worst case scenario). My stress level went off the charts and I spent much of my weekend in a fog. Called Madi's doctor, who didn't seem too concerned about the lump, and finally calmed down by Sunday night. This morning, the lump has reduced greatly in size and is almost non-existent. I would have taken her in for a check-up over the weekend but because the lump had a tiny, tiny whitehead at the bottom of it, the doctor felt inclined to suggest it was probably a cyst or boil. Still don't know what exactly it was but wow, was that scary! Now that that issue is resolving, I'm able to get back on track for planning for Friday's sleep study. I'm going to watch the videos you sent and will probably be back with some prep questions within a few days. Thanks again, Lorenzomama, for your support and quick replies! You seriously rock!

I found that, once I knew that my son had some confusing health issues going on, so many things scared the heck out of me... I'm glad your stress level has come down a bit.

Good luck tomorrow, to all of you! I hope all goes well.