Sleep apnea - surgery or not?

My 2 year old daughter has been sick for the past four months. When she first got sick, she got antibiotics and was seeming to get better, and then when she was almost better, she got another cold or flu again. So it's been back to back illnesses.


She's lost weight during that time but she's never been a good eater. She has sleep apnea because she can't breathe through her nose.


On the one hand, I'm wondering whether it's just normal for someone her age to be sick as it's approaching the flu season. But because of her blocked nose, she can't ever get a good night's sleep, which probably leads to her weight loss and lack of appetite. She eats a few mouthfuls every mealtime.


We have tried this steroid nasal spray from our ENT specialist. It seemed to help, but not completely, plus we can't use steroids for too long.


Some questions:


1. do you think surgery is too drastic and it's just typical of HK doctors to want to go that route? (but then, my daughter has been sick for 4 months??)


2. anyone had success with a milk-free diet? (this has been suggested to us, so we are using soya milk and soy-based formula - will there be a problem of her not getting enough calcium?)


I'm reluctant to have surgery but I just want my daughter to have a good night's sleep. I'm sick of seeing her suffer every night. Last night, she had chills and then fever and then threw up everywhere. She also threw up everywhere a week ago. I don't know whether this is just a passing cold/flu, or whether her immune system is so wrecked cos she just can't sleep and eat properly...


I'm seeing Terry Hung (ENT Centre). I'm thinking of getting a second opinion - does anyone have any suggestions?


Thanks very much!

Hi,I was in the same situation as you when one of my twin boys,now 6 had poor weight gain and his speech wasn"t clear.He was seeing a speech therapist and through the same ENT clinic arranged to have a sleep study done at the Sanitorium hospital.Waste of time and money the results were given and I was told he had no apnea.His speech therapist and I worked out what was wrong with him,andafter seeing various private docs being told he was ok I knew as a Mother he wasn"t.

I went to see Dr Sally Levy,Hangkow Center,TST and she was the only Dr to do a throat swab which came back with low grade virus.So antibiotics plus manuka honey,vit c and echinecha spray he kept getting repeat infetcions plus waking up looking pale,dark eyes and no weight gain.We were referred to the public hospital(speeded up with his repeated infections )

Saw a wonderful ent doc at the Nethersole in Tai Po who said the results of his sleep study read that he did have sleep apnea and recommended a tonsilectomy straight away.I decided to monitor his tonsils with the Dr to see if they would improve.....and they didn"t.So in April this year he had his op done and his adenoids were removed due to completely blocking his nose.

The care he has recieved at the public hospital is fantastic,my boy still gets infections moreso than his brothers FYI his twin brother is 10kg heavier and his twin brothers 20 months younger are the same weight at 20kg and at 6years and being Western indicates we have a long way to go yet.

He is sat on my legs as I write this to you with another fever:(:(:( his ENT doc is concerned at his lack of weight and next month we see the pediatrician to run some tests.We think he may have a gluten intolerance which can be caused by too much antibiotics.

I know an adult who had her tonsils removed in her thirties and she said it took her 2 years to fully recover and that she didn"t realise how ill her tonsils were making her till they were removed.The nose spray we used is nasonex which cannot be used for too long.Would def recommend Dr Levy shes a GP very old school and offers no nonsense advice.tel-2366 9110 follow your gut instinct like I did and I hope your daughter makes a full recovery(worst time of year)Was thinking of him getting the flu shot but have to wait till he"s better first:(:(.

There"s nothing worse than having a poorly child and no matter what you do they keep getting poorly again so my heart goes out to you.Def get second opinion.Sarah

"only Dr to do a throat swab which came back with low grade virus.So antibiotics"


Why would a doctor prescribe antibiotics for a virus? Antibiotics have no effect on viruses.

Hi Sarah,


Thanks for your post. Hope your son's fever gets better. Interesting also that with twins, you can really compare their growth and development and see the effects of the sleep apnea.


A neighbour referred me to her paeditrician, who just so happens to be at the Sanatorium Hospital - so I'm definately not going to bother doing a sleep study there! However, I got an allergy test for my daughter and the results came back today. She tested positive for egg white and cow's milk.


Incidently, Terry Hung dismissed the idea of doing an allergy test, saying that she didn't have runny eyes and sneezing so she probably wasn't allergic to anything!


So I'm faced with two choices: we can remove the egg white and cows milk from my daughter's diet, but it could take several months before her inflamed adenoids improve - which means several months of sleepless nights, and possibly medication (antihistamines) to try and help her sleep. Or we could just get her adenoids removed and see immediate benefits.


I always think surgery should be the last resort, but it sounds like the adenoid-ectomy (whatever you call it) is pretty straight-forward and painless and recovery is great. And possibly a better option then medicating a child longterm.


Tomorrow, we go back to the paeditrician at the Sanatorium just to discuss the test results. I was also thinking of seeing Dr Adrian Wu, who - from reading the forums - is a paediatric allergist.


I wonder if anyone else has had similar problems with allergies and sleep apnea? I don't believe our daughter has severe allergies. She's been eating eggs and drinking milk since one year of age, and she's now 2.5years.

I meant low grade infection(heavy growth of haemophilus parainfluenzae )the HKS was used by our ENT Dr so basicaly we hired the room from them and then a technican connected all the wires to my sons body.He looked like a robot covered in wires,dont think I would sleep with them on me.

I slept in the room with him so they didn"t video him sleeping which they should have done.His oxygen level dropped which set off an alarm so I called a nurse who said "don"t worry"and reset it.

After the operation there was hardley any blood,the surgeon had done a really good job.Hope you find the right Dr,there is a really good one cannot remember his name who trains the ENT Drs at the POW in Shatin.Vander something? If you have medical cover try him.Good luck

Ah. That makes sense. Thx for clarifying.

My son used to get sick frequently with flu like symptoms and similar to yours could not sleep through the night also when his Paed saw his tonsils he said that my son has sleep apnea. He also suggested that we do a 'sleep study' to see if its dangerous. He also said that as my son grows up and as his body develops he will grow out of the condition. We decided not to go for surgery because though he sleeps with his mouth open and snores, he does not seem to get any 'breathlessness/gagging ' attacks. If your daughter has apnea you need to see if she wakes up in the night choking. Each kid is different .

Regarding the frequent flu attacks, kids tend to fall sick very often in HK till the age of 4. As long as they are going to a 'play school' they are bound to pick infections from here and there. My son now ,5, is much better regarding his flu/ coughing. After a thorough checkup the doctor found out that most of his coughing was due to allergy. He prescribed an inhaler which I did not want to give him (he was 3 then). The doctor then suggested some powder which he had before sleeping, the result of which was he was able to sleep through the night without coughing fits. The powder apparently helped in opening his nasal zone. He had also stopped drinking milk and had switched to Soya milk. My son got better within 2 months (touch wood).

Regarding calcium, milk is not the only source of calcium. Green leafy vegetables such as spinach/ lettuce are excellent source. If that does not work try giving vitamin/ calcium supplements.

He is 5 now and though he catches the occasional cold, he does not get his coughing fits anymore.


Hope this helps..

Hi RA,


Thanks for your reply.


At night, sometimes our daughter can sleep okay. But most of the time, she's very restless and you can see her body moving a lot and even her frustration at night time because she can't breathe properly. And almost every night she'll have those gagging attacks that you mention.


We've stopped the allergy foods so I'm hoping to see some improvement in the next week or so. Last night, she slept fairly well so I'm hoping that this will continue so that we don't have to consider surgery.


For myself, I would be happy to continue with the antihistamines and hope to see some improvement over the next few months. The paed says it will take this long for the inflamed adenoids to reduce in size and allow for easier breathing.


However, my husband wants my daughter to have immediate relief because he's worried about the impact on her growth and development if she can't get a good night's sleep. I also worry about the affect on her growth.


I didn't realise until recently that sweating is a symptom of sleep apnea because the body is working extra hard at night time to try and breathe. Our daughter has always had a sweaty head for as long as I can remember and I could never understand why.


It's difficult to know what to do... we have a choice of longterm medication (antihistamines), and possibly recurring cold/flu symptoms... or we do surgery and hopefully significantly reduce illness/medication.


I'm glad we found out about her allergies though. I suppose we should consult a paed allergist about managing or overcoming her allergies? Or we wait for her to outgrow them?

I would probably seek a second opinion in the government hospitals, even if through the private bit of the public hospital. There seems to be quite an intervention, medicine/drug driven culture in HK and I would not be 100% certain that removing the tonsils will result in resolution of your child's problem.


Also antibiotics don't cause gluten allergies.coeliac disease, it's immunological.

I would certainly explore other routes before surgery. Surgery should not be taken lightly at any age. You mention food allergies, have you had your daughter tested for food intolerences? An ELISA food intolerance test may be one way to go If you can't find a good doctor to do the test, you can buy them and send off for the results. Also as her immune system is low a 25 hydroxy vitamin D test to check her vitamin D status may help too.

I see you've removed some foods, it can take up to three months to get the body fully clear of the effects of food allergies, so be patient. It also takes time for the gut to heal too.

Hi, thanks for your replies, will consider further tests. Unfortunately it takes a long time to get a public hospital appointment so I think we'll have to stick with private.

slammy not true. it is only a long wait if you go as a public patient if you go as a private patient you can get in v quickly and you would be seen by the consultants/professors not a trainee but then you would have to pay

Depends which hospital as well we had a 4 month wait which got speeded up going to A&E and done internally which was reduced to about 6weeks.Back next Tuesday for check-up with pediatician,6 years old weight 20.9kg this morning against his twin brothers 30kg so somethings not right and his twin brothers 20 months younger are 1kg less :(:(not sure what tests to suggest.

Hi Sarah,


Hope your twin boy gets healthier...


We are thinking of doing the sleep study - it seems Sanotorium are the ones who offer sleep studies for very young (my daughter's 2). If we go to public, then I can get an appointment immediately, but then I don't know how long I need to wait for sleep study etc. So I'm thinking to do the sleep study privately and then at least we would have something to show the specialist at the public hospital.


You can still hear the blockage in my daughter when she breathes but there has been some slight improvement. So I think I would like to do a sleep study and see what the experts think. However, my husband is a bit skeptical, because some nights my daughter is okay, and other nights she's really bad. So what if we get a sleep study done on the night that she's ok?


Maybe the recent humid weather has also helped...

Try filming her yourself when she's "blocked up".When they do the sleep study you will be sleeping in the room with her,make sure they record her sleeping.My boy still moves a lot,some nights more than others and also sometimes has the sweaty head too.Hope alls well

hi there, short answer: my son had sleep apnea and enlarged adenoids.


Everytime he had an infection he wouldnt get enough rest. he would 'sleep' hours and hours, but wake up tired.


got his adenoids out, and presto: situation improved dramatically. I did not like dor terry of ent.

check out dr hui at pedder clinic. he's expensive but good..

Why didn't you like Dr Terry Hung?


My daughter was getting better for a fortnight but then after returning to school she got sick again. It might have been because a neighbour gave her two tiny little cakes which probably have egg in it... but we can't be sure.


But I agree with what you say. I'm sick of seeing my daughter suffer - it's horrible watching her trying to breathe while she's sleeping. We've scheduled the surgery for two weeks time with Terry Hung.