Child sleep apnea occurs when she or he regularly stops breathing for two breath cycles or longer during sleep. It can be mild, moderate or severe, depending on the number of times in an hour that the breathing stops (apnea) or becomes very shallow (hypopnea). For children, 1.5 apneas or hypopneas per hour are abnormal. There are three types of sleep apnea: obstructive sleep apnea, central sleep apnea, and mixed sleep apnea. Obstructive sleep apnea, also called OSA, is by far the most common in children.
What causes Obstructive Sleep Apnea?
A blockage or narrowing of the airways in the nose, mouth or throat generally causes obstructive sleep apnea (OSA). This constriction usually occurs when the throat muscles and tongue relax during sleep and partially block the airway. In children, sleep apnea is often caused by excess tonsillar tissue. Even if the tonsils do not appear large, they may be too large for the small airway.
During the day when the child is awake and standing up, this may not cause problems. However, when the child lies down at night, the tonsils and other relaxed tissues in the throat can press down on the airway, narrowing it and causing sleep apnea.
Obesity is also a risk factor for sleep apnea in children, as are allergies, asthma, gastric reflux, and bone deformities of the face or jaw.
What are the symptoms of sleep apnea?
Children who have sleep apnea almost always snore or have heavy, labored breathing. Studies report that 10-20% of school-age children snore. It is impossible to distinguish simple snoring from sleep apnea without a sleep study. Other symptoms may include breathing during sleep that seems too shallow or quiet because children have a tendency to hypo ventilate and restless sleep during which your child wakes up often. Your child may bend his/her neck while sleeping or have trouble with bed-wetting. All of these symptoms may be caused by sleep apnea.
The hallmark symptoms are behavior and learning problems that result from chronic, unrecognized sleep deprivation. It is rare for a school age child to be sleepy in the daytime. If your child acts sleepy, it is likely that the child has serious sleep deprivation. However, most children with sleep apnea usually do not appear to be very sleepy during the day (which is a key symptom in adults). In fact, often they act “hyperactive” with difficulties focusing or following directions, and usually there are mood disturbances. Sometimes the only symptom is poor academic performance. The only symptom of sleep apnea in some children may be that they do not grow as quickly as they should for their age.
Should I worry about sleep apnea?
Yes. Child sleep apnea seriously disrupts the quality of sleep and there is a growing awareness of the vital role sleep plays in children’s growth and development. Also, when your child stops breathing or breathes very shallowly during sleep, it may result in less oxygen (and more carbon dioxide) in his or her blood. Over time, this lack of oxygen can lead to serious health problems and learning difficulties. If a children have untreated sleep apnea, they are more likely to get high blood pressure (hypertension), high blood pressure in the lungs (pulmonary hypertension), and heart failure (in very severe cases).
If children have sleep apnea, they often have difficulty concentrating, paying attention and remembering what has been learned. Children can be misdiagnosed with a learning disorder or with ADHD when the problem is really an underlying sleep disorder. Because of the mood disturbances caused by chronic sleep deprivation, children with sleep apnea can be misdiagnosed with depression or other psychiatric illnesses.
How is Sleep Apnea diagnosed?
A sleep specialist will examine your child and ask you and your child questions about his/her snoring and sleep behavior. If your doctor thinks your child may have sleep apnea, he or she may suggest a sleep study. The American Academy of Sleep Medicine recommends an overnight sleep study if there is any suspicion of sleep apnea because studies have shown that doctors cannot predict from the size of the tonsils which child has sleep apnea. Sleep studies find out how often your child stops breathing or has shallow breathing and how much oxygen and carbon dioxide are in his/her blood during sleep. The treatment is often a tonsillectomy which results in a cure in 80-90% of cases.
If you have questions or would like a consultation, …
…please give us a call at 847-674-3600. We can help you find out if you or someone you love has sleep apnea or another disorder that may benefit from treatment.