Children and Sleep Apnea: Symptoms, Causes & Treatment

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Raj Dasgupta, MD

Sleep apnea means you stop breathing while sleeping. This can mess up your sleep and make you tired during the day. Kids might act up more when they have it.

There are two kinds: obstructive sleep apnea (OSA) and central sleep apnea (CSA). With OSA, your airway gets blocked, so you can’t breathe properly. With CSA, you just kinda forget to breathe for a bit.

OSA is more common in kids than CSA. About 1-5% of kids have OSA, but it’s often not noticed.

Knowing what causes sleep apnea in kids and its symptoms can help you decide when to talk to a doctor. There are tests and treatments available for it.

Symptoms of sleep apnea in children

Children and Sleep Apnea

Here are some signs of sleep apnea in children:

  • Loud snoring
  • Coughing or choking while asleep
  • Pauses in breathing
  • Breathing through the mouth
  • Sleep terrors
  • Bedwetting
  • Sleeping in odd positions

These symptoms can happen during the night, but they can also affect your child during the day. Daytime symptoms may include:

  • Feeling tired
  • Falling asleep during the day
  • Having trouble waking up in the morning

In babies and young kids, sleep apnea might not always cause snoring, especially if it’s central sleep apnea. Sometimes, the main clue that something’s wrong is if they have a hard time sleeping peacefully.

What’s the Difference Between Sleep Apnea in Adults and Children?

Sleep apnea makes it hard for both adults and children to get good sleep, but how it affects them during the day can be different.

Adults might feel really tired and sleepy during the day, while children might have trouble focusing and might be extra hyper.

When it comes to treating sleep apnea, it’s different for kids. Adults often use a machine called CPAP, but for children, surgery is more common.

Some treatments like braces can only help kids who are still growing, so adults don’t have that option.

Causes and risk factors of sleep apnea in children

Obstructive sleep apnea and central apnea are two different sleep problems with their own causes and risks. Let’s break it down:

For obstructive sleep apnea, it happens when the muscles in the throat relax too much during sleep, making it tough to breathe. This is more common in adults, often linked with being overweight. But in kids, it can be because of big tonsils or adenoids that block the airway.

Some studies suggest that African American kids might have it more often and worse than other kids, but we need more research to be sure. Other things that can raise the risk include a family history of sleep apnea, certain health conditions like cerebral palsy or Down syndrome, or having a big tongue.

Now, let’s talk about central apnea. This happens when the brain doesn’t tell the body to breathe during sleep. It’s rare in kids, except for newborn babies, especially those born too early. Some factors that can increase the risk for central apnea include medical issues affecting the brain, spinal cord, or heart (like heart failure or stroke), certain medications (like opioids), or some birth defects.

Effects of untreated sleep apnea in children

Here’s how untreated sleep apnea can affect children:

  • Disturbed Sleep: Without treatment, sleep apnea can lead to long periods of disturbed sleep, causing chronic daytime fatigue.

  • Learning Problems: Children with untreated sleep apnea might struggle to pay attention in school, which can lead to learning difficulties and poor academic performance.

  • Misdiagnosis of ADHD: Some kids may appear hyperactive due to sleep apnea, leading to a misdiagnosis of ADHD. Studies suggest that treating sleep apnea can improve these symptoms.

  • Social and Developmental Challenges: Untreated sleep apnea can make it hard for children to thrive socially. In severe cases, it can cause growth delays, cognitive issues, and heart problems. Treating sleep apnea can help improve these complications.

  • Health Risks: Untreated sleep apnea can contribute to high blood pressure, increasing the risk of stroke and heart attack later in life. It may also be linked to childhood obesity.

Diagnosing sleep apnea in children

To check if a child has sleep apnea, the doctor will ask about their sleep and any problems during the day or night. They’ll also look at the child’s mouth, neck, and throat for signs like big tonsils.

If needed, they might suggest a sleep study called polysomnography. This test is done at a sleep clinic while the child sleeps. It’s painless and gives accurate results. Home tests aren’t usually recommended for kids, according to guidelines from medical experts.

Potential Complications of Sleep Apnea in Children

Sleep apnea in kids can cause big problems if not fixed. It can mess up their body and mind. Here are some issues it can cause:

  1. Not growing well: Kids might not get bigger like they should.
  2. High blood pressure: Their blood pressure might get too high.
  3. Heart problems: Their heart might not work right.
  4. Trouble in school and with feelings: They might find it hard to do well in school and control their emotions.

Treatment for Sleep Apnea in Children

When kids have sleep apnea, their breathing pauses during sleep. Here’s how doctors might help:

  1. Monitoring and Lifestyle Changes: If it’s mild and doesn’t bother them, doctors might just keep an eye on it. Sometimes, kids grow out of it. If obesity is a factor, doctors might suggest exercise and healthy eating.

  2. Nasal Steroids: If the problem is a stuffy nose, doctors might give nasal sprays like fluticasone or budesonide to help clear it up. They use these for a few months to see if they help.

  3. Surgery: If large tonsils or adenoids block the airway, doctors might take them out. This helps the air flow better. Sometimes, just removing the adenoids works well, especially for younger kids with moderate sleep apnea.

  4. CPAP Therapy: If the problem is severe or doesn’t get better with other treatments, kids might need to use a CPAP machine. This machine gives a steady flow of air through a mask to keep the airway open while they sleep.

  5. Oral Appliances: These are like mouthguards that keep the jaw forward to help the airway stay open. Kids might find them easier to use than CPAP machines.

  6. NIPPV: For kids with central apnea (where the brain doesn’t send the right signals to breathe), there are special machines that help them breathe regularly.

  7. Apnea Alarms: These are used for infants with central apnea. They sound an alarm if the baby stops breathing, which wakes them up.

Remember, treatments depend on what’s causing the sleep apnea and how severe it is. It’s important to work with doctors to find the best solution for each child.

Learn more: Best Anti-Snoring Devices

When to See a Doctor?

If you or your child are having weird sleep problems, it’s smart to see a doctor. Kids who don’t sleep well might have trouble paying attention, get grumpy, or have a hard time controlling themselves.

If your child is acting out, it’s worth asking the doctor if a sleep problem like sleep apnea could be part of the issue.

Need professional help to diagnose and address your sleep problems? Schedule an online consultation with sleep specialist Dr. Owen Napleton.

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