Sleep apnea is a sleep disorder characterized by repeated breathing interruptions during sleep as a result of a partly or completely blocked airway. It is estimated that about 26% of the adult population have the disorder, while at least 2 to 3% of children are believed to have sleep apnea and 10 to 20% of children who habitually snore.
Unfortunately, many parents don’t even know that their child has obstructive sleep apnea (OSA) because the disorder can look different in children and adults. For example, adults experience extreme daytime sleepiness, whereas children have behavior problems, poor concentration, etc. In children, OSA can affect growth, learning, behavior, and heart health, which is why early detection and treatment of pediatric obstructive sleep apnea is essential.
That said, if your child snores, sleeps with the mouth open, and has behavioral issues, ensure you consult a specialist to see whether OSA is to blame. To learn more, continue reading below.
What is Pediatric OSA?
As already noted, obstructive sleep apnea is a disorder in which a person experiences frequent breathing pauses during sleep. These pauses can occur every couple of minutes or even more frequently. Also, the breathing between pauses is shallow, while after the pause, breathing becomes normal and can sometimes be accompanied by a choking sound or a loud snort.
Common symptoms of pediatric obstructive sleep apnea might include:
- Snoring, often with pauses
- Snorts or gasps between breaths
- Coughing and choking in sleep
- Restless sleep
- Bedwetting
- Night time sweating
- Heavy breathing during sleep
- Mouth breathing
- Daytime sleepiness
- Behavioral problems
- Poor attention
- Poor weight gain
What are the Causes of OSA in Children?
The main risk factor of obstructive sleep apnea is obesity. However, even though excess weight can contribute to sleep apnea in children, mainly among teenagers, it is most common in adults. In children, the major cause of obstructive sleep apnea is enlarged tonsils and adenoids. Other causes might include low airway tone like cerebral palsy or Down syndrome.
Other risk factors for obstructive sleep apnea in children include:
- Prader-Willi syndrome
- Inherited blood disorders (sickle cell disease)
- Skull or face birth defects
- Neuromuscular disorders
- Low birth weight
- Family history of OSA
How is OSA Treated in Children?
Firstly, you have to get a diagnosis, which will require a medical history review, a physical examination, and possibly some tests like a polysomnogram, oximetry, and electrocardiogram. After being diagnosed, your child’s doctor should be able to identify the issue causing pediatric obstructive sleep apnea.
In most cases, enlarged tonsils and/or adenoids are the reason for OSA in children. Therefore, the doctor may refer you to an ear, nose, and throat specialist who will determine whether your child needs a tonsillectomy (removal of the tonsils), an adenoidectomy (removal of the adenoids), or both. Indeed, this is the most effective treatment of OSA in children with enlarged tonsils and/or adenoids.
However, if the tonsils and/or adenoids are removed or aren’t the cause of OSA, and symptoms persist, your child may undergo a sleep study or a sleep endoscopy, which is an examination of the airways during sleep. This will help doctors determine the next steps of the treatment process, which may include special sleep equipment that helps your child breathe during sleep by keeping the airways open.
Last but not least, in children who are obese or overweight, a key step in the process is weight loss. Losing weight will reduce the amount of soft tissue at the base of the tongue or in the nose and allow the airway to widen, thus improving airflow.