A new study suggests that a common asthma drug may be able to help children with sleep apnea avoid surgery.

Children with obstructive sleep apnea may be tired by day, have trouble paying attention in school, and have other behavioral problems because they are not getting enough quality sleep at night.

Surgery to remove the tonsils and adenoids is often recommended, but many parents are reluctant to subject their kids to any type of surgery.

New research in the September 2012 issue of Pediatrics suggests an allergy and asthma drug -- montelukast (Singulair, which just went generic) -- may lessen symptoms in children with non-severe apnea and potentially allow them to skip the surgery.

Sleep apnea is marked by pauses in breathing while asleep. Sleep apnea is often a result of an obstruction in the airway, with severity of children's sleep apnea linked to the size of tonsils and adenoids. These pauses can occur throughout the night and disrupt sleep.

Asthma Drug Improves Apnea Symptoms

Forty-six children with non-severe sleep apnea received the asthma drug or a placebo for 12 weeks. The kids who received the drug showed improvements in tests measuring the degree of their sleep apnea, their sleep-related symptoms, and the size of their adenoids compared to their counterparts who didn't. There were no side effects seen among kids who took the study drug.

Study authors are quick to caution that this study is small and it's preliminary. Bigger studies following more children for longer periods of time are needed before this treatment is offered to any kids with sleep apnea.

Michael Rothschild, MD, also urges caution in interpreting the new findings. He is the director of pediatric otolaryngology at Mount Sinai Medical Center in New York City.

It's too early to recommend montelukast for the treatment of sleep apnea in kids. But, "it does make sense," he says. "The drug reduces inflammation in the nose and adenoids."

That said, longer follow-up is needed. "Let's do a big, long-term study in a bigger group of kids and follow them for six months or one year."

Until then, if you think your child has sleep apnea, the first step is to confirm this suspicion. "With kids, the risk is not stopping breathing, but more that it is disturbing their sleep," he says.

Sleep apnea in children may be measured in several ways. These include:

• The gold standard sleep study conducted overnight in a lab
• A home sleep study where children are hooked up to a monitor while they sleep
• Videotaping of the child in the throes of what parents believe to be an apnea episode

Drug May Be Band-Aid, Not Cure

Parents also need to know that while no one wants their children to undergo surgery, removal of tonsils and adenoids is safe. "Parents often say 'anything but surgery,' and 99.9% of the time, they are terrified of anesthesia," Rothschild says.

Yosef Krespi, MD, is the director of the Center for Sleep Disorders at the New York Head & Neck Institute of Lenox Hill Hospital in New York City.

He says the allergy and asthma drug may be more of a Band-Aid, but is likely not a cure for sleep apnea in kids. "The follow-up is too short and the number of cases is too limited," he says.

There are often several factors that cause sleep apnea, and this only addresses one of them, he says.

SOURCES:Michael Rothschild, MD, director, pediatric otolaryngology, Mount Sinai Medical Center, New York City.Goldbart, A.D. Pediatrics, September 2012.Yosef Krespi, MD, Director, Center for Sleep Disorders, New York Head & Neck Institute, Lenox Hill Hospital, New York City.

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