Obstructive Sleep Apnea in Children

If your child is snoring and showing other signs of disturbed sleep such as bedwetting and pauses in breathing, you may need to consider the idea that he or she has sleep apnea. Researchers estimate that between 1 and 4 percent of children have sleep apnea, and large number of them range between the ages of 2 years old and 8 years old.

Some people believe that sleep disorders are simply a part of childhood and children will just grow out of them, but this is not a healthy approach. Left untreated, sleep apnea can have long-term negative effects on physical health as well as mental and emotional health. Lack of sleep in children can set in motion habits and struggles that could affect a child for their entire life. Learning difficulties, behavior problems, social struggles, hormonal problems, weight gain, stunted growth, and even failure to thrive have all been linked to sleep apnea in children.

Child Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is a serious condition in which the person stops breathing for extended periods of time at intervals during sleep. This negatively affects the body and brain in a variety of ways. When a child stops breathing periodically during the night, the brain perceives this a choking which causes alarm, arousing the brain and sending out “fight or flight” hormones as if the body is in an emergency. This arouses the brain and makes it much harder to get to sleep after this happens.

Pauses in breathing also mean that the brain and body are not receiving as much oxygen as they should be for several hours of time every day. This lack of oxygen often causes the heart to begin having to work harder and beat faster in order to try to keep the blood flowing through the body to provide oxygen. For some people, this can result in high blood pressure that continues in the daytime too, as well as heart problems including arrhythmia, enlarged heart, and even stroke. Metabolic syndrome and weight gain leading to obesity may also be caused by interrupted sleep.

One significant consideration experts are observing is the crossover of symptoms related to ADHD and sleep apnea in children. In fact, studies have suggested that up to 25% of cases of ADHD are misdiagnosed and truly represent the symptoms and signs related to the underlying cause of sleep apnea.

Symptoms and Signs of Obstructive Sleep Apnea in Children

If your child is exhibiting these signs and symptoms of sleep apnea, contact a medical professional for a complete exam and diagnosis:

  • Loud snoring (approximately 10% of children who snore have sleep apnea)
  • Pauses in breathing during sleep
  • Heavy breathing/mouth breathing during sleep
  • Bedwetting recurrences (enuresis)
  • Daytime sleepiness
  • Behavioral or learning problems
  • Similar symptoms as Attention Deficit Hyperactivity Disorder (ADHD)
  • Restless sleeping
  • Sleeping in unusual positions

Causes of Sleep Apnea in Children

Some of the most common causes of sleep apnea in children are:

  • Enlarged Adenoids or Tonsils. The most common cause of sleep apnea in children, adenoids and tonsils are part of the lymphatic system have a tendency to become enlarged or swollen in children and may result in blockage of the airways. Adenoids and tonsils are glands that can easily be removed with a simple surgery, and are possible for older children to live without. As children grow into adulthood, these glands notably shrink until they have basically disappeared, meaning that they are completely unnecessary into adulthood.
  • Enlarged Tongue or Neck. Some children have an enlargement of the tongue or fat deposits at the back of the neck that can get in the way of breathing, causing the airway to narrow and eventually close during sleep. This may be due to a physical formation, or related to being overweight or obese.
  • Recessed Jaw. Craniofacial abnormalities such as an oddly shaped lower jaw can have a significant impact on nighttime breathing and cause sleep apnea in children.
  • Underlying Health Problems. Some children with health problems such as cerebral palsy or other neuromuscular deficits may have loose tissues and muscles in the throat that do not stay open as they should during sleep, causing problems with breathing.

Diagnosis of Sleep Apnea in Children

Just as with adults, children who are exhibiting symptoms or signs should take part in a sleep study to determine if they have sleep apnea. A medical professional will arrange for a sleep study to be performed on your child, most likely in a sleep clinic. During a sleep study, measurements will be taken that may include blood oxygen levels, brain activity, body movements, eye movements, breathing patterns, snoring, or heart rate.

A sleep study is non-invasive and without risk, but the child will be attached to sensors in order to take measurements and provide information about the presence of and severity of sleep apnea. These sensors might seem a bit scary to some children, so it’s important to be sure that the sleep clinic you use is adept at accommodating children. Some families may prefer to try to have their child’s sleep study performed at home, but certain sleep doctor’s do not find this to be as effective.

Mild Obstructive Sleep Apnea in Children

Children who have mild obstructive sleep apnea should be seen by an otolaryngologist (ear, nose and throat doctor) or other specialist to determine the best form of treatment. Treatment will be determined by the cause. For instance, if the problem is related to adenoids or tonsils being enlarged, then treatment may require surgery for removal of these glands. A child who is severely overweight may need to be placed on a careful diet and exercise regimen in order to lose weight and restore proper nighttime breathing. Other children may need to make use of a Continuous Positive Airway Pressure machine (CPAP) in order to restore breathing to appropriate levels at night.


Obstructive sleep apnea in children is a very serious condition that can cause significant problems in a child’s health and development. Positively, this sleep disorder offers many treatment options that can be managed in cooperation with your healthcare professionals. Whether through surgery, weight loss, or the use of a CPAP machine, children with sleep apnea have a positive prognosis that can ultimately provide them with a normal, healthy future for years to come.

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