Childhood sleep apnea disrupts breathing during sleep, often due to relaxed airway muscles leading to blockages. Common causes include enlarged tonsils, adenoids, obesity, chronic allergies, or low muscle tone linked to conditions like Down syndrome or Pierre Robin syndrome. Structural abnormalities in the airway or face can also contribute. Around 2–3% of children experience obstructive sleep apnea. Learn more about pediatric obstructive sleep apnea diagnostic criteria in the article by Snuggle Cubs.
What is Childhood Sleep Apnea?
Childhood sleep apnea is a sleep disorder characterized by temporary interruptions in a child’s breathing during sleep, usually caused by partial or complete blockage of the upper airway. These disruptions can lead to restless sleep, daytime fatigue, and, if untreated, may negatively affect a child’s growth, behavior, and overall health.
Unlike adults, children with sleep apnea rarely exhibit excessive daytime sleepiness. Instead, behavioral issues are more common. While obesity is the primary cause of sleep apnea in adults, children are more often affected due to enlarged tonsils or adenoids. Tonsils are oval-shaped tissues located at the back of the throat, while adenoids are small tissues at the rear of the nasal cavity.
Understanding pediatric sleep disorders is critical for early diagnosis and treatment, which can prevent future complications and improve a child’s developmental well-being. Symptoms such as enlarged tonsils or chronic allergies should prompt parents to seek medical advice, leading to better health outcomes and an enhanced quality of life for the child.
Child sleep apnea symptoms
If your child suffers from OSA, you may observe the following:
- Loud snoring, pauses in breathing, and difficulty breathing during sleep.
- Retching, coughing, or gasping during sleep.
- Restlessness and sweating during sleep.
- Sleeping in unusual positions, such as with the head raised on the pillow.
- Breathing through the mouth instead of the nose at night.
- Suffering from headaches and/or fatigue in the morning.
- Having a stuffy nose, poor appetite, and/or difficulty swallowing.
- Sometimes the only problems a child with OSA may experience are difficulty concentrating, behavioral problems, and learning difficulties.
>>> Read the full guide: Is Snoring in Children Dangerous? Causes and Treatments
Causes and Risk Factors of Childhood Sleep Apnea
The most common cause of OAS in children is enlargement of the tonsils at the back of the throat, the adenoids at the back of the nose, and the turbinates (small bony structures) in the airways. The tonsils and adenoids grow most rapidly between the ages of two and seven. Removing the tonsils and adenoids cures OSA in 80–90% of children. However, sometimes the adenoids grow back. If symptoms reappear, the child may need another operation.
Other causes of OSA:
- Obesity
- Chronic allergies or hay fever
- Certain diseases associated with muscle weakness or low muscle tone, such as Down syndrome
- A very small jaw or flat face in children.
Risk Factors
Other risk factors for childhood sleep apnea include:
- Genetic disorders such as Down syndrome or Prader-Willi syndrome.
- Congenital defects of the skull or face.
- A group of disorders called cerebral palsy, which affect movement and posture.
- A group of inherited blood disorders known as sickle cell anemia.
- Conditions called neuromuscular disorders, which affect muscle function due to problems with the nerves and muscles in the body.
- Low birth weight.
- A family history of obstructive sleep apnea.
Diagnosing Childhood Sleep Apnea
If you suspect that your child has childhood obstructive sleep apnea, it’s important to consult your GP. Your child may be referred to a pediatrician or an ear, nose, and throat (ENT) specialist. The doctor may recommend overnight sleep monitoring, either at home or in a hospital setting, to help confirm the diagnosis.
The diagnosis involves a series of steps that the doctor takes to determine whether the child has obstructive sleep apnea. The doctor will review the child's symptoms and medical history and perform a physical examination. He or she will likely examine the child's head, neck, nose, mouth, and tongue.
Additional tests may be necessary. The most important test for detecting sleep apnea in children is polysomnography. This is a nighttime sleep test. Sensors are attached to your child's body. These sensors record brain waves, breathing patterns, snoring, child sleep apnea oxygen levels, heart rate, and muscle activity while your child sleeps. This test can be performed at a sleep center.
Childhood sleep apnea treatments
Once a proper diagnosis is made, treatment for childhood sleep apnea will depend on its cause and severity.
- Children with enlarged tonsils or adenoids may be recommended for surgery, specifically childhood sleep apnea removal of adenoids
- For children who are overweight, lifestyle changes such as regular physical activity, healthy eating, and weight management may significantly reduce symptoms.
- Children with mild symptoms may benefit from establishing a consistent sleep routine and making other lifestyle adjustments to support better sleep quality.
- In some cases, particularly for moderate to severe sleep apnea, a CPAP (Continuous Positive Airway Pressure) machine may be prescribed to help keep the airway open during sleep.
- Children with structural issues, such as jaw or palate abnormalities, may require specialized dental devices or orthodontic treatments to help realign the jaw and expand the airway.
- A small number of children may need more advanced or specialized interventions, depending on their individual condition.
Long-term effects of childhood sleep apnea
If left untreated, sleep apnea in children can lead to significant complications, impacting their physical, emotional, and cognitive development. Prompt diagnosis and treatment are critical to support healthy growth and overall well-being.
Poor Growth
Inadequate sleep from untreated sleep apnea can interfere with the release of growth hormones, hindering physical development. It may also affect weight regulation due to disrupted hormone production.
Behavioral Issues
Childhood sleep apnea and ADHD are often closely linked, as the symptoms can overlap. Sleep apnea can cause irritability, hyperactivity, and mood swings in children, which may resemble the behavioral patterns commonly associated with ADHD. This overlap can make diagnosis challenging. Poor sleep affects emotional regulation and behavioral control, making sleep apnea child behavior appear impulsive, inattentive, or overly active.
Cardiovascular Problems
Frequent oxygen deprivation caused by sleep apnea places stress on the heart and blood vessels. Over time, this can increase the risk of high blood pressure and other cardiovascular complications.
Learning Difficulties
Children with untreated sleep apnea may struggle with memory, focus, and problem-solving skills. Poor-quality sleep reduces their ability to concentrate and retain information, leading to academic challenges.
FAQs
Does childhood sleep apnea go away?
Some children can overcome obstructive sleep apnea under the supervision of their treating physicians. This is especially true for children with mild forms of the disease and without additional risk factors.
Does my child have sleep apnea quiz?
Wondering if your child might have sleep apnea? Take this quick quiz to help identify potential symptoms: Does My Child Have Sleep Apnea? – Start the Quiz
What is the best sleeping position for child with sleep apnea?
The best sleeping position for a child with sleep apnea is usually on their side. Sleeping on the back is often the worst position, as it allows gravity to pull the tongue and soft tissues backward, narrowing the airway and increasing the risk of vibration and obstruction. Side sleeping can help keep the airway more open and reduce breathing disruptions during the night.
What are the signs of sleep apnea in children?
Symptoms of obstructive sleep apnea in children include:
- Snoring, often with pauses, snorts, or difficulty breathing between breaths.
- Heavy breathing during sleep.
- Extremely restless sleep.
- Bedwetting especially in children who were previously dry at night may be a sign of childhood sleep apnea and bedwetting issues.
- Daytime sleepiness or behavioral problems.
>>> Learn more about: Establishing the Baby Bedtime Routine: A Guide for Parents
Conclusion of the article
Childhood sleep apnea is a serious condition that can impact a child's physical, cognitive, and emotional well-being. Early detection and treatment are essential for effective management. By recognizing the symptoms, understanding risk factors, and exploring treatment options, parents can significantly enhance their child’s quality of life and minimize health risks. With prompt and appropriate care, children with sleep apnea can achieve better overall health and well-being.
