As sleep apnea—and other forms of sleep-disordered breathing—gain recognition and awareness in mainstream culture, many people assume that these breathing disorders affect only adults. And while the vast majority of new cases of apnea are diagnosed in the adult population, doctors are seeing increased numbers of children exhibiting symptoms of sleep-disordered breathing. The symptoms, risk factors, ramifications, and treatments in the pediatric population can be quite different than in their adult counterparts.
Current estimates state that from 1 to 3 percent of the current US pediatric population suffer from the most common form of sleep-disordered breathing, Obstructive Sleep Apnea (OSA). And, like adults who suffer from the same disorder, the first sign of OSA is usually snoring. While this symptom alone cannot conclusively diagnose OSA (up to 20 percent of children will show some degree of snoring, often intermittently), there are other signs that may point to some form of sleep apnea.
Signs, Symptoms & Risk Factors
- Snoring at night
- Difficulty waking up
- Excessive daytime sleepiness
- Headaches during the day
- Labored breathing while sleeping
- Restless sleep
- Blue-ish tint to the skin while sleeping
- Breathing through the mouth consistently
- Enlarged tonsils and adenoids
- Irritability, aggressiveness, or excess agitation
- Abnormal urine production and/or bedwetting
- Failure to thrive or slow growth
- Daytime hyperactivity or a diagnosis of ADD or ADHD (now thought to possibly be related to untreated sleep apnea in certain cases)
Evaluations for Childhood Sleep Apnea
As awareness increases about the pervasiveness of sleep-disordered breathing in the population, more and more physicians have sleep apnea on their radar, but parents may still need to push for a sleep study if concerns exist. Pediatric OSA can often be difficult to diagnose as the symptoms are non-specific and can be indicative of many normal aspects of childhood. Untreated OSA in children can often have severe ramifications, with some studies showing negatively affected growth, IQ, and school performance.
To diagnose OSA definitively, the child should see an ENT (ear, nose and throat) specialist for evaluation. An examination and detailed catalog of symptoms by someone familiar with OSA in children will most likely lead to a polysomnography – the same type of sleep study done in adults to monitor the patient for signs of OSA or other sleep disorders.
Treatment for Pediatric Obstructive Sleep Apnea
Treatments for OSA in children are generally quite different than for those in adults (who are almost always recommended CPAP treatment). The first recommendation for children is generally surgery to remove the (often enlarged) tonsils and adenoids. In up to 90% of cases this surgery will resolve the disordered breathing problems without further treatment.
Other treatments may include allergy treatment, weight loss plans (if needed), nasal steroids, or CPAP therapy. It is important to remember that children with an OSA diagnosis may not continue to experience sleep-disordered breathing when they get older.
References and Links for More Information
Could My Child Have Sleep Apnea?
Having Your Child Evaluated for Obstructive Sleep Apnea
About Pediatric Sleep Apnea
Kids and Sleep Apnea
Sleep Apnea at KidsHealth.org