Sleep Apnea in Children

A common but serious sleep related disorder, sleep apnea affects not only adults but children as well. Sleep apnea in children is a dangerous condition in which the affected person stops breathing at intervals throughout sleep, causing them to be deprived of oxygen as well as sleep. Lack of oxygen to the brain and interrupted sleep can have a significant impact on a child’s ability to develop properly, learn appropriately, and grow up in a healthy manner.

While the prevalence of sleep apnea in childhood is much lower than in adulthood (5% in children compared to 25% or more in people over age 30), the risks of children with untreated sleep apnea should not be ignored.

Child Sleep Apnea Symptoms

Here are some of the most common signs and symptoms found in children with sleep apnea:

  • Loud snoring (around 10% of children who snore also have sleep apnea)
  • Breathing pauses during sleep
  • Mouth breathing
  • Daytime sleepiness
  • Difficulty concentrating and poor school performance
  • Behavioral issues (similar to ADHD)
  • Poor attention span
  • Bedwetting

As many as ¼ of children who are diagnosed with ADHD may actually have learning and behavioral difficulties due to sleep disordered breathing or other sleep abnormalities. Obtaining a diagnosis for a child with sleep apnea can have a huge outcome for treating what may otherwise be frustrating problems that seem to have no cause and won’t seem to go away.

Diagnosis for sleep apnea, whether for a child or an adult, consists of a sleep study. For a child, this may be able to be performed at home with the oversight of a parent or other adult. The test measures various things that are happening in the body and brain during sleep, with non-invasive machines. This may include testing oxygen levels, heart rate, blood pressure, breathing levels, body movements, stages of sleep, brain activity, eye movements, and possibly other factors related to sleeping.

Once the test is complete, a diagnosis of sleep apnea will occur. If your child has sleep apnea, the sleep study should also indicate how mild or severe your child’s case of sleep apnea is. This will help to determine what the course of treatment should entail.

The diagnosis of severity for a child with sleep apnea typically has very different criteria than that of an adult. The index for adults with sleep apnea is:

  • Mild sleep apnea: 5-14 breathing interruption episodes per hour
  • Moderate sleep apnea: 15-30 episodes per hour
  • Severe sleep apnea: 30 or more episodes per hour

For children, the indications are as follows:

  • Mild sleep apnea: 1-5 interrupted breathing episodes per hour
  • Moderate sleep apnea: 5-15 episodes per hour
  • Severe sleep apnea: 15 or more episodes per hour

Childhood Sleep Apnea Causes

Often with different causes than sleep apnea in adults, childhood sleep apnea should be diagnosed and treated by a medical professional with experience in pediatric sleep disturbances. If your child is diagnosed with sleep apnea, your doctor will perform an examination and possibly some tests to determine the particular cause so that it can be treated most effectively.

In 90% of cases of childhood sleep apnea, the cause is related to swollen, enlarged adenoids and/or tonsils that block airways and keep the respiratory system from working properly during sleep.

Other causes of airway blockage during sleep in childhood sleep apnea may include seasonal allergies, asthma, recessed jaw or other dental malformations, childhood obesity or being overweight. The good news is that there is a relief in sight for children who are suffering from sleep apnea.

Childhood Sleep Apnea Treatments

Because the most common cause of sleep apnea in children is enlarged adenoids or tonsils, surgery is often indicated for approximately 90% of cases of childhood sleep apnea. This type of surgery removes the tissues in the neck and throat that are blocking the child’s ability to breathe, offering almost immediate relief and correcting symptoms for a lifetime.

The other common cause of sleep apnea in children is childhood obesity. With this in mind, a positive and healthy lifestyle program is likely to benefit the child most. This may include adding exercise and activity, managing weight with nutrition, and generally encouraging healthy activity. Doctors may also indicate the use of a Continuous Positive Airway Pressure (CPAP) machine to induce healthy breathing during sleep. This can allow the child the ability to sleep better while on a weight reduction plan, so that he can get back to a healthy weight and eventually may not need to use the CPAP machine any longer.

Older children whose sleep apnea is caused by a recessed jaw or improper facial bone growth may benefit from the use of an oral or dental appliance. In this case, the appliance is fitted by a specialized dentist and placed in the mouth during sleep. This will keep the tongue or neck tissues from slipping back into the breathing passages to cause blockage.

Finally, some children’s sleep disorder breathing problems may be related to allergies or asthma that cause barriers for breathing. In this case, doctors may recommend allergy medications, asthma medications, inhalers, or even humidifiers to help keep the breathing passages open and oxygen flowing through readily.

Once your child has received treatment for sleep apnea, you may be pleasantly surprised to find that she is not only less sleep deprived and tired, but she also has turned into a healthier, happier person. You may notice behavioral issues and personality problems lessening or even completely resolving themselves. Talk to your child’s teacher or school counselor if these continue to be a problem.


Sleep apnea doesn’t have to be a scary disorder in a child, but it should be taken seriously, with diagnosis and treatment by a medical professional as soon as it is discovered. If your child is experiencing some difficult symptoms related to sleepiness, hyperactivity, poor school performance or other signs, start by observing his or her sleeping patterns. If you discover any abnormalities, contact your doctor right away as the first step toward a healthier life for your child.

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