Learning About Sleep Apnea in Children

What is it?

Sleep apnea means that breathing stops for short periods during sleep. When your child stops breathing or has reduced airflow into the lungs during sleep, your child doesn't sleep well and can be very tired during the day. The oxygen levels in the blood may go down, and carbon dioxide levels go up. This may lead to other problems.

Sleep apnea can range from mild to severe, based on how many times in an hour that your child stops breathing while sleeping.

Obstructive sleep apnea is the most common type. It most often occurs because your child's airways are blocked or partly blocked. Large tonsils or adenoids, or obesity, can cause this type.

Central sleep apnea is less common in children. It can occur in children who have a central nervous system problem, such as a brain tumor or epilepsy.

Some children have both types. That's called complex sleep apnea.

What are the symptoms?

Children who have sleep apnea nearly always snore. But unlike adults with sleep apnea, they may not seem very sleepy during the day.

In younger children, other symptoms include:

• Mouth breathing.
• Sweating.
• Feeling restless.
• Waking up a lot.

In older children, other symptoms may also include:

• Bed wetting.
• Doing poorly in school.
• Behavior problems.
• A short attention span.
• Not growing as quickly as they should for their age. This may be the only symptom in some children.

In rare cases, sleep apnea in children can cause developmental delays and failure of the right side of the heart (cor pulmonale).

How is it diagnosed?

To diagnose sleep apnea, the doctor will gather information about your child's symptoms and general health.

• During a routine checkup, your doctor will ask you and your child about snoring. If your child snores, be sure to tell your doctor.
• A complete sleep study usually is needed to find out if your child has sleep apnea and isn't just snoring.
• Children may need to see a specialist if they have sleep apnea.

How is it treated?

Children have most of the same treatment options as adults.

• Enlarged tonsils or adenoids are a common cause of sleep apnea in children. Surgery to remove them is usually the first treatment.
• If surgery isn't possible or you'd like to try nonsurgical options, children may be treated with continuous positive airway pressure (CPAP). This device delivers air through a mask to help keep your child's airways open during sleep.
• A bilevel positive airway pressure machine (BPAP) works like CPAP. It's sometimes called BiPAP. It uses different air pressures when your child breathes in and out.
• Your child may also get a corticosteroid or saline spray. These are given through the nose.
• In some cases, getting a dental device that widens the mouth can help.
• If your child is overweight, your doctor may use a plan to help with weight loss. The treatment plan may include nutrition and activity programs. It may also include counseling.