Does your child suffer from sleep apnea? How to say and what to do

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Pediatric Sleep Apnea is relatively common, affecting 1 to 4% of children. Like adults, children with obstructive sleep apnea experience breathing interruptions while they sleep because their airway muscles collapse, leading to daytime sleepiness or potential behavioral problems. In the long term, if left untreated, sleep apnea in children can lead to serious health complications, such as stunted growth or heart problems.

The good news is that the symptoms are fairly mild for most children and often resolve. Here’s what you need to know if you suspect your child has sleep apnea.

What causes sleep apnea in children?

There are two main types of Sleep Apnea in children – obstructive sleep apnea and central sleep apnea. With obstructive sleep apnea, the muscles in the airways collapse in on themselves, blocking your child’s ability to breathe. Central sleep apnea occurs when the brain does not send the correct signals to the muscles in the airways.

We will mainly talk about obstructive sleep apnea, because it is more common than central sleep apnea. There are several causes of sleep apnea in children, such as narrow facial bone structures, cleft palate, or high or low muscle tone.

However, two main factors are major contributors to OSAS in children.

Obesity

According to a cross-sectional study of children aged 7 to 18, obesity contributes significantly to sleep apnea. About 44% of children classified as overweight had OSA, compared to a prevalence of 9.1% in the “normal weight group”.

As in adults, obesity is one of the main risk factors for sleep apnea. This happens because fat deposits build up in the upper airways, limiting muscle activity.

Enlarged tonsils and adenoids

Sleep apnea can occur in children due to enlarged tonsils or adenoids. The tonsils are in the back of the throat and the adenoids in the nasal cavity. If either is enlarged, it can narrow the child’s airways, making it difficult for them to breathe while they sleep. The severity of the respiratory interruption will depend on the side of the tonsils or adenoids. It doesn’t happen to all children, and it’s not clear why it happens to some and not others. Exposure to viruses, bacteria, or other infections can enlarge the tonsils or adenoids.


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Common Signs and Symptoms of Sleep Apnea in Children

Your child probably won’t be able to tell you what’s going on. As a rule, they fall asleep after any interruption in breathing without knowing that they have woken up. If your child complains of being tired during the day or his behavior has changed, note what happens when he sleeps.

Snoring is not always necessary to diagnose a child with sleep apnea, although it is the most common indicator. However, there are several other signs.

Signs of sleep apnea in children include:

  • Snoring and gasping at night
  • Mouth breathing or heavy breathing
  • Night sweating
  • Wet the bed
  • Sleepwalking or night terrors
  • Agitated sleep
  • Difficulty waking up or staying awake
  • Behavioral issues

What happens if pediatric sleep apnea is left untreated?

Just because your child snores doesn’t mean they have sleep apnea. If you suspect they might have it, it’s worth looking into. The effects of untreated sleep apnea can be serious – high blood pressure, risk of stroke, and heart problems all increase with sleep apnea.

There are differences between sleep apnea in adults and children – most of which are evidenced in the side effects of the disorder. Children with sleep apnea will likely exhibit behavioral issues due to their fractured sleep patterns. They may have trouble waking up in the morning, paying attention in school, or being hyperactive. If sleep apnea is not treated, your child may experience behavioral and learning difficulties.

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Treatments for pediatric sleep apnea

After a physical exam and a detailed sleep history, a sleep study is best for diagnosing pediatric sleep apnea. In a pediatric sleep study, your child’s sleep will be monitored in a lab where a doctor can note any abnormalities in sleep apnea symptoms.

Once diagnosed, treatment for your child’s sleep apnea will generally fall into these three categories. However, special cases may require unique treatment options.

Operation

One of the biggest contributing factors to sleep apnea in children is the enlargement of the tonsils or adenoids. Your ear, nose, and throat doctor may recommend removing one or both to effectively cure obstructive sleep apnea – surgery results in the elimination of sleep apnea symptoms in 70-90% of the time.

After surgery, you should expect a sore throat. Children with sleep apnea who have their tonsils and adenoids removed are more likely to have lower oxygen levels for the first two to three nights after surgery.

Continuous Positive Airway Pressure Machine

Your child’s doctor may also recommend the use of a CPAP machine to treat their sleep apnea. CPAP machines constantly blow air into your child’s airways, making sure they don’t close overnight. Although they effectively treat sleep apnea, they require your child to wear the mask when sleeping.

Sleeping with a CPAP machine will be an adjustment. We recommend that you introduce the machine slowly. Try it first at nap time, then for longer periods each night. This will help them adapt to change and adapt better.

If your child can’t tolerate a CPAP machine, your doctor may recommend an oral device to treat his sleep apnea, which pushes his tongue and jaw forward, widening his airways at night. Oral appliances are less effective, but most children adapt more easily to them. This option is usually limited to those who have had surgery to remove their tonsils and adenoids, and sleep apnea persists.

Regime change

Along with other treatment options for sleep apnea, lifestyle changes will be recommended for children who are considered overweight. Research has shown that weight loss successfully treats sleep apnea in children. Talk to your doctor about a nutrition and exercise plan that promotes a healthy way to lose weight.

Remember that getting enough sleep is a crucial part of weight management. Children who don’t get enough sleep are more likely to gain weight. A CPAP machine can help give them more restful sleep for weight loss aid.

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When should your child see a doctor?

The big question you are probably asking yourself is: What should I do first if I think my child has sleep apnea?

In general, you shouldn’t try to self-diagnose your child’s sleep apnea. If your child regularly has any of the symptoms associated with sleep apnea — snoring, short of breath or restless sleep – you should consult a doctor. It’s never too early to start a conversation.

Tips for preparing for your appointment:

  • Be sure to bring any questions you want answered. Feel free to talk about anything that comes to mind.
  • Be prepared to explore treatment options that you are comfortable with. Express your concerns and hesitations.
  • If you are looking for additional support, you can connect with your local AWAKE group, an education and support group run by the American Sleep Apnea Association.

The information in this article is for educational and informational purposes only and is not intended to constitute medical or health advice. Always consult a physician or other qualified health care provider with any questions you may have about a medical condition or health goals.

About Keith Johnson

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