Obstructive Sleep Apnea in Children

Obstructive sleep apnea is repeated, brief, temporary breathing pauses (apneas) during sleep. Lack of breathing reduces oxygen and increases carbon dioxide (CO2) in the body. These changes signal the brain that breathing has stopped. The brain then signals the body to briefly awaken and restart breathing.

These repeated, brief disruptions in sleep (imagine being poked by someone 15 to 30 times a night) could lead to major daytime symptoms in children. However, children are usually unaware of waking up, and parents often describe very restless sleep but usually are not aware their child wakes up completely.

In most children, sleep apnea is caused by large tonsils or adenoids, which can block the airway. Sleep apnea is also more common in children who have a higher weight for their age, although some children with enlarged tonsils and adenoids may weigh less for their age.

Younger children with sleep apnea may have poor growth, because their nighttime secretion of growth hormone is disrupted. Other children who are at high risk for sleep apnea include those with a narrow facial bone structure, a history of cleft palate, and Down syndrome. Children with allergies, asthma, reflux or frequent sinus infections may also be at risk for obstructive sleep apnea.

• Snoring
• Breathing pauses during sleep or difficulty breathing during sleep
• Mouth breathing
• Noisy breathing
• Restless sleep
• Sweating during sleep
• Morning headaches
• Nasal voice

Children with obstructive sleep apnea may also have daytime symptoms because of the sleep disruption. They may be sleepy during the day, take unplanned naps or fall asleep in school. Children with sleep apnea may also be moody, irritable or cranky. In addition, your child may have behavior problems and poor performance in school.

Many children with symptoms of obstructive sleep apnea require an overnight sleep study to confirm the diagnosis. The sleep study is done in a specialized sleep laboratory where breathing, heart rate and sleep interruptions are monitored overnight.

For most children with sleep apnea, removal of tonsils and adenoids, if enlarged, takes care of the problem. An ear, nose and throat specialist (ENT) makes the evaluation for such surgery.

For children who are at a higher weight for their age, dietitians don’t recommend weight loss. Help your child gain weight at a slower rate as they grow taller. Let them grow into their weight. Consult with a dietitian or healthcare provider before attempting a weight loss program if your child is still growing.

We may prescribe medicines to treat your child if they have allergies or asthma.

We may recommend nasal sprays or sleeping positions to help lessen snoring.

Some children benefit from a portable breathing machine used at night, called continuous positive airway pressure (CPAP).