A Parent’s Guide to Sleep Apnea in Children

Sleep apnea is commonly misunderstood as a disease that only affects overweight adults. Contrary to this preconceived notion, sleep apnea can also affect children. In fact, according to the American Sleep Apnea Association, an estimated 1% to 4% of children between the ages of 2 and 8 years old have sleep apnea.

How to Identify Sleep Apnea in Children

Three months after bringing home their infant, Kevin and Amanda Cook noticed their son, Caden, began having episodes of breathing pauses during sleep. Amanda watched her son go “just completely limp” and “unresponsive,” and had to rouse him repeatedly to get him to breathe again. At six months, Caden was taken to the Lucile Packard Children's Hospital in Palo Alto, California and was diagnosed with both obstructive and central sleep apnea. The former occurs when the airway is blocked during sleep, and the latter takes place when the brain fails to regulate the breathing muscles during sleep.

Sleep apnea is a widely misdiagnosed medical condition, and it can affect children as well as adults. An estimated 1%–4% of children in the age bracket of two to eight years have sleep apnea. There are multiple causes of the condition, but age and weight are said to be the main contributing factors in adults, while adenoids and enlarged tonsils are seen as common causes of sleep apnea in children. Some of the other less common factors that can contribute to the condition’s development in children are: down syndrome; storage disease; hypothyroidism; sickle cell disease; congenital syndrome, which can lead to oral, facial, and throat anomalies that disrupt the airways; neuromuscular diseases that lead to abnormal muscle tone in the pharyngeal constrictors; and cerebral palsy. If sleep apnea is not treated in time, it can cause severe damage to the overall health of the child. Sleep, as we are all aware, is very important, especially during a child’s formative years, since that is when the brain is also beginning to establish itself. In the case of disturbed or interrupted sleep, the brain tends to sustain injuries, which often accumulate through the disruption of oxygen being delivered, thereby causing an executive function wherein the brain is impaired.

It is thus very important for parents to observe their children carefully for any of the early symptoms of this medical condition, one of the classic signs being snoring. Others can include chronic instances of breathing from the mouth when sleeping, long pauses while breathing during sleep, feeling restless and constantly tossing and turning in bed, bedwetting, and night sweats. During the daytime, children may express behavioral issues, excessive sleepiness, have difficulty concentrating, or speak with a nasally voice. As soon as any of these symptoms appear, parents should take their child to see a doctor for diagnosis. A diagnostic tool known as a polysomnogram can be used to rule out or diagnose sleep apnea. But the main challenge is getting the child to cooperate during this technique.

Currently, there are no universally accepted rules or guidelines for determining whether or not a child has sleep apnea or if it is severe enough to require medical or surgical intervention. When it comes to treatment, then, the doctor will suggest the appropriate option based on the symptoms present. If the cause is enlarged tonsils or adenoids, for example, they may need to be surgically removed, but those children who suffer from obesity or certain complications of OSA would first need to undergo an overnight breathing observation. If surgery is not recommended, the doctor will suggest trying positive airway pressure therapy. It is important that this medical condition is identified during childhood so that it does not lead to any issues while the child is growing.