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  • Q&A with Australian Health Practitioners

    14 year old very loud snorer what to do next

    My 14-year-old snores very loudly and wakes with a headache. He had his adenoids and tonsils removed just over a year ago. He has a deviated septum as well. Do you think it is a good idea to get a sleep study done?
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    Dr Nicholas Wilsmore

    Respiratory & Sleep Medicine Physician

    Dr. Wilsmore in an Australian trained specialist, with International fellowship expertise in Interventional Pulmonology. Nick has unique expertise in the interventional diagnosis and management of … View Profile

    The lack of response to upper airway surgery with regards to the snoring certainly increases his likelihood of having other issues, such as obstructive sleep apnoea. We know that even mild degrees of OSA in children can have substantial adverse effects on development. A proper assessment by a sleep physician is warranted, who will be able to determine the need or not for an appropriate in-laboratory sleep study. 

  • Expertise in dental sleep medicine / oral appliances for management of sleep disordered breathing (snoring and sleep apnoea) with mandibular advancement splints (MAS). For 12 … View Profile

    Check the BMI! Loud snoring will persist in obese cases, despite T/A.  In this age group, patient is best managed with examination of the airway, starting with dental malocclusion. A retrognathic profile and/or constricted maxilla can be treated with palatial expansion and/or jaw position with a variety of appliances, fixed or removable. Palatal expansion is proven to increase nasal volume and tongue posture. Traditional mandibular advancement splints (MAS) and CPAP are not recommended in the growing individual. Ideally this is undertaken by an orthodontist with an interest in sleep disordered breathing in collaboration with a R&S Physician. More extreme cases are treated surgically with maxilla-mandibular (MMA) advancement, although this is not so common. Diagnostic sleep study may assist in presence of other symptoms eg excessive daytime somnolence or mood disorder.

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