Sleep apnea is a condition in which breathing is interrupted during sleep. These pauses in breathing affect sleep quality and can lead to daytime sleepiness and behavior issues in children.
The two types of sleep apnea are obstructive sleep apnea (OSA) and central sleep apnea (CSA). In OSA, a person tries to breathe but is unable to because of a constricted or blocked airway. In CSA, there is typically a lack of effort to inhale, so a person briefly stops taking breaths. Similar to adults, OSA is much more common in children than CSA.
Researchers estimate that between 1-5% of children have obstructive sleep apnea. Although studies have shown obstructive sleep apnea to be relatively rare in children, it is also commonly underdiagnosed.
Knowing the causes and symptoms of sleep apnea in children can help you determine when to see a pediatrician. There are tests available to diagnose sleep apnea and treatments that can help manage or resolve this condition.
There are several causes of obstructive sleep apnea in children:
Central sleep apnea can occur for a variety of reasons in children. It is important to note that a few central apnea events during sleep is considered normal. Central sleep apnea has been associated with rare genetic disorders in children, such as congenital central hypoventilation syndrome. It may also be present when children have health conditions that interfere with parts of the central nervous system that controls breathing.
Snoring is a hallmark symptom of obstructive sleep apnea. However, not all children who snore have sleep apnea, and not all children with sleep apnea snore. Only a doctor can determine whether a child’s symptoms are due to sleep apnea.
In addition to snoring, other symptoms of sleep apnea in children during sleep include:
Sleep apnea also causes detrimental symptoms during waking hours. These may include:
First, a doctor gathers information from the child and parent or guardian about the child’s sleep habits and any daytime and nighttime symptoms. The doctor may also perform a physical examination of the child’s mouth, neck and throat to look for physical characteristics that increase risk for sleep apnea (such as enlarged tonsils and adenoids).
If this initial evaluation indicates further testing is appropriate, the doctor may suggest polysomnography, which is a sleep study performed overnight at a sleep clinic. Polysomnography involves measuring specific body functions while a person is sleeping. It is painless and noninvasive. Polysomnography is the gold standard method for evaluating suspected sleep apnea, as it provides the most definitive results.
Home sleep tests are generally not recommended for children, based on the American Academy of Pediatrics and the American Academy of Sleep Medicine guidelines.
Treatments for childhood sleep apnea depend on the cause and severity of symptoms and should be discussed in detail with the healthcare provider:
Additionally, children with very mild or no symptoms may be monitored over time without administering treatment. Supportive care during watchful waiting can include education on good sleep habits, close monitoring of symptoms and frequent follow up with the healthcare provider.
The following natural treatments may help reduce obstructive sleep apnea in children. A child’s healthcare provider will be in the best position to discuss the risks and benefits of the natural treatment listed below:
Sleep apnea leads to poor-quality sleep in all affected people, but the daytime symptoms can be different between adults and children. Adults are more likely to exhibit daytime sleepiness and fatigue, while children are more likely to show behavior issues such as difficulty concentrating and hyperactivity.
Additionally, sleep apnea is treated differently in children. In adults, the most common treatment is CPAP, while the most common treatment for children is surgery. Certain orthodontic treatments are only helpful in actively growing children and are not an option for adults with sleep apnea.
It is a good idea to consult a doctor anytime abnormal sleep symptoms are present. Also, children who are not sleeping well may have trouble focusing, display irritability, or have poor impulse control. If a child is struggling with behavior concerns, it could be helpful to ask the doctor whether a sleep disorder such as sleep apnea may be a contributing factor.