Steroids and Sleep Apnea

Pediatrics for Parents, June, 2001 by Harry Pellman

Many children with large tonsils and adenoids snore while sleeping and may actually stop breathing for a very short while. The amount of oxygen in the child's blood decreases (desaturation of the hemoglobin). The child will suddenly jerk or even awaken to restart the breathing. This problem, called sleep apnea, is usually treated with surgical removal of the child's tonsils and adenoids.

Doctors at the Children's Hospital in Montreal, Canada, decided to see if use of a nasal steroid spray (Flonase) on a regular basis would lessen the severity of the children's sleep apnea. To test their hypothesis, they enrolled 25 children 1-10 years old with proven sleep apnea.

The children received 200 micrograms a day for one week and then 100 micrograms a day for the next five weeks. The researchers reasoned that the higher dose was needed to help shrink the tissue, and the lower dose would maintain the smaller size.

The results were impressive with decreased frequency of episodes of stopping breathing, desaturation of hemoglobin, and movements/ arousals required to stimulate the restart of breathing. Interestingly, the size of the tonsils and adenoids didn't change.

More studies are needed to verify these results. However, this study opens up interesting possibilities for avoiding surgery.

Journal of Pediatrics, 6/01