How Do I Know If My Child Has Sleep Apnea ?

Between one and four percent of American children have sleep apnea, with a significant number of them ranging in aged between 2 and 8 years old. This means that your preschooler or young school aged child who breathes strangely at night, is tired and irritable during the day, wets the bed, or exhibits behavioral problems may be struggling due to a completely treatable sleep disorder: obstructive sleep apnea (OSA).

OSA is a condition in which the person’s airways are physically blocked during sleep which creates pauses in breathing. This type of disorder has a variety of symptoms, some of which may not be as obvious as others. If you believe that your child may have sleep apnea, don’t be afraid. While the condition is as serious sleep disorder, it is able to be treated—sometimes in very non-invasive ways.

Signs of Sleep Apnea in a Child

If your child is exhibiting some of these symptoms and signs, it is possible that he or she has sleep apnea and should be examined by a medical professional:

  • Loud snoring (around 10% of children who snore have sleep apnea)
  • Mouth breathing/heavy breathing during sleep
  • Observed pauses in breathing during sleep
  • Snorts or choking sounds along with snoring and breathing pauses
  • Daytime sleepiness or fatigue
  • Bedwetting problems (enuresis)
  • Restless sleeping with thrashing, tossing and turning
  • Learning and/or behavioral problems such as hyperactivity
  • Diagnosis of ADHD (Attention Deficit Hyperactivity Disorder)
  • Unusual sleep positions
  • Heavy sweating during sleep
  • Difficulty waking up in the morning
  • Headaches during the day, particularly in the morning
  • Falling asleep during activity or “spacing out”

Diagnosis of Sleep Apnea in Children

The first step in determining if your child has sleep apnea is to ask your pediatrician or family doctor for a referral to a specialist. This may be a sleep specialist or possibly an otolaryngologist (ear, nose, and throat doctor). This doctor will then ask about the reasons you suspect sleep apnea in your child and schedule an examination. If needed, a sleep study will be recommended.

The only way to definitively diagnose childhood sleep apnea is through a sleep study. This study (polysomnography) is normally performed in a sleep clinic which should feel more like a comfortable hotel room rather than a hospital. During the study, your child will be attached to a variety of machines to monitor certain aspects of his or her health. These monitors are non-invasive but involve sensors that will be attached to different parts of the body such as the head and chest.

Once attached to the sensors, your child will go to sleep as normally as possible and the machines will take measurements such as heart rate, breathing rate, body movements, oxygen levels, brain activity, and other important information. After the sleep study, if your child is given a diagnosis then your doctor will either make treatment suggestions or possibly refer him or her to a surgeon, specialized dentist, or other specialist with the means of treating your child’s specific cause of sleep apnea.

What Causes Sleep Apnea in Children?

The causes of sleep apnea in children may be the same as in adults or they may be very different. In all cases, obstructive sleep apnea (OSA) occurs because something is physically blocking the breathing passages causing pauses in breathing during sleep.

Here are some of the possible causes of obstructive sleep apnea in children:

Enlarged Adenoids and Tonsils. One of the most common reasons that breathing passages are obstructed in children is due to swelling or enlargement of these glands that are part of the lymphatic system. Sometimes

Extra Fat in the Neck and Throat. Possibly due childhood obesity or being overweight, extra fat in the throat and neck areas may obstruct a child’s narrow airways and develop into sleep apnea. This may be treated with weight loss, surgery, or a CPAP (Continuous Positive Airway Pressure) machine, depending on the child’s needs.

Facial Formation Issues. Some children have craniofacial malformations that cause airway blockage when sleeping, which may include a recessed jaw or cleft palate. In this case, your child may be referred to a dentist who specializes in such cases. Treatment may consist of a dental mouthpiece worn while sleeping, or possibly surgery depending your child’s specific situation.

Allergies or Asthma. Sometimes children’s airways are blocked during sleep due to asthma or allergy problems. Your doctor may recommend certain medications, humidifying the air in the bedroom, and possibly the use of a CPAP machine.

Certain Health Disorders. Children with certain underlying health problems may experience sleep apnea as a result. For instance, children with cerebral palsy may have problems with the muscular function in the respiratory system leading to blocked airways during sleep. Down syndrome is another condition that affects the upper airway and can have a much higher incidence of sleep apnea. In fact, more than half of children with have Down Syndrome will likely develop sleep apnea.

Heart Problems. Lack of oxygen makes the heart have to work much harder in order to pump the oxygen throughout the body. Left untreated, this could ultimately result in high blood pressure and other heart problems such as enlarged heart, heart disease, or stroke.

Stunted Growth. Development and growth during childhood is definitively linked to sleep. When a child is not getting enough restorative sleep, the body can go into a sort of survival mode and begin limiting growth.

Learning Struggles. As many as 25% of children diagnosed with ADHD may actually have an underlying problem with sleep apnea that remains undiagnosed. As the behavioral symptoms and signs are often similar, a proper diagnosis is missed and the children continue on with treatment for ADHD when what they truly need treated is the underlying cause of sleep apnea.


Allowing sleep apnea in a child to go undiagnosed and untreated is a serious mistake and could be the cause of a lifetime of problems. On the other hand, with some simple care from a medical professional team, you can restore your child to his or her premium state of health and possibly even find a solution to certain behavioral and learning problems as well.

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