Sleep Apnea in Children
Sleep apnea is one of the nation’s most common sleep disorders, affecting 1 in 4 men and nearly 1 in 10 women. However, did you know that an estimated 2 million children under the age of 11 in the U.S. also suffer from sleep apnea? In this article, you will learn what pediatric obstructive sleep apnea is, how it affects children differently than adults, and how to diagnose and treat it.
What is Pediatric Obstructive Sleep Apnea?
Pediatric sleep apnea is when your child’s breathing repeatedly pauses during sleep. A common way this happens is when the upper airway is blocked. This is known as obstructive sleep apnea (OSA).
When your breathing stops, your oxygen levels decrease, causing your body to wake up to resume breathing. For adults, these interruptions prevent them from getting restful sleep, leaving them with daytime sleepiness. However, for children, this sleepiness often translates to behavioral problems, short attention spans and difficulties in the classroom.
What causes sleep apnea in children?
During sleep, the muscles in the back of the throat that keep the upper airway open relax. With obstructive sleep apnea, these muscles relax too much, causing the airways to close.
For children, enlarged tonsils and adenoids (muscle tissue that captures germs coming into the throat) are also a common cause, as they also block the airway during sleep. In adults, sleep apnea is typically caused by obesity; however, for children, there are many other risk factors, such as:
- Cerebral palsy
- Down syndrome
- Mouth, jaw or throat abnormalities, such as a large tongue or small jaw
- A family history of OSA
- Childhood Obesity
What are the signs and symptoms of obstructive sleep apnea in children?
According to the Mayo Clinic, if you believe your child may have sleep apnea, look out for these symptoms during their sleep:
- Repeated pauses in breathing
- Restless sleep
- Mouth breathing
- Unusual sleeping positions
- Noisy breathing
In the daytime, your child may also experience:
- Attention-deficit / hyperactivity disorder
- Behavior problems at home
- Poor school performance, due to attention difficulties
If you begin to notice these symptoms regularly, you should follow-up with your pediatrician. They may recommend you see a sleep specialist or take a sleep study to confirm if your child has OSA.
Sleep studies, also known as polysomnograms, are painless overnight tests sleep specialists use to diagnose sleep disorders, including OSA. Most adults can get diagnosed from the comfort of their own homes by signing up for a home sleep test; however, it is recommended that young children spend the night at a sleep center to perform the study, because children are more likely to shift sensors during the night.
After the study, you will receive an Apnea Hypopnea Index (AHI), which measures the number of apneas (pauses in breathing) and hypopneas (intervals of shallow breathing) per hour of sleep on average. The higher this number is, the more severe your child’s condition is.
|Less than 5||No Sleep Apnea|
|5 – 15||Mild Sleep Apnea|
|15 – 30||Moderate Sleep Apnea|
|Greater than 30||Severe Sleep Apnea|
How is obstructive sleep apnea treated in children?
Before making any decision, please be sure to work with a sleep medicine specialist to come up with the best treatment options for your child’s medical condition.
The most common sleep apnea solution for children is surgery. If your child has enlarged tonsils or adenoids, your doctor may refer your family to an ears, nose and throat specialist to perform a tonsillectomy or adenoidectomy to remove them. These procedures may improve sleep apnea symptoms by removing these airway obstructions.
Although surgery is the most common therapy, it might not be the one best suited for your child. Fortunately, there are plenty of methods to look into.
According to the Mayo Clinic, some topical nasal steroids may relieve your child’s symptoms, as these medicines reduce inflammation in the airways, allowing for normal breathing.
In some cases, if weight is causing your child’s obstructive sleep apnea, working with your pediatrician to develop a safe and healthy weight-loss plan would be a natural solution to sleep apnea.
In other cases, positive airway pressure therapy may work best for your child. A continuous positive airway pressure (CPAP) machines blow air through a tube into a mask that covers either your child’s nose, nose and mouth, or face. The machine creates air pressure that opens your child’s airway during sleep. Most CPAP masks that fit for adults unfortunately would not fit for children. However, CPAP machines are universal.
About the Author
Dr. Nicholas Walter, MD is a Geriatric Medicine Specialist in Phoenix, AZ who has over 7 years of experience in the medical field. He graduated from the School of Radiologic Technology at Saint Josephs Medical School in 2013. He is affiliated with Banner Boswell Medical Center.