An estimated of 1 to 4% of children between the age of 2 and 8 years are affected by sleep apnea in the United States. Sleep apnea is a fairly common condition, but often poorly diagnosed. It has consequences on a child’s daily life, but treatment is only possible once the syndrome is diagnosed.
What Is Sleep Apnea?
Sleep apnea is the partial or complete obstruction of the airway during sleep. There are two major types of sleep apnea that can affect both children and adults.
- Obstructive Sleep Apnea Syndrome (OSAS) is the partial or complete obstruction of the airway during sleep. The passage of air is blocked even as the child makes an effort to breathe.
- Central Sleep Apnea Syndrome (CSAS) – The mechanism of the breathing itself works badly. The muscles that lift the rib cage so that the lungs inflate with air do not work properly. It is much rarer and generally related to neuromuscular diseases.
Chances of Getting Sleep Apnea in Children
Children who are born prematurely, have asthma, allergic rhinitis, recurrent ENT infections, have significant gastroesophageal reflux, and/or at least one of whose parents has sleep apnea are at a higher risk of this condition.
Children of all age groups, from only a few months of age to 18 years may be affected, but sleep apnea is usually diagnosed in children between 2 to 8 years of age, then in adolescence, between 12 and 16 years.
Sleep Apnea Symptoms in Children
An irritable, tired child who sleeps with an open mouth may suffer from obstructive sleep apnea. Other symptoms include:
- Sleepiness during daytime
- Drowsiness or tiredness
- Difficulties in concentration and learning
- Difficulty in focusing
- Pauses in breathing while sleeping
- Hyperactivity, anger or aggressiveness
Diagnosis of Sleep Apnea
The diagnosis is made following a medical history assessment and a clinical examination. Imaging may be required to look for a facial abnormality or enlarged tonsils. The quality of the child’s sleep during the night or during a nap can be recorded at home or in a sleep laboratory (polysomnography). Early diagnosis avoids complications such as stunting, chronic fatigue or delayed intellectual development.
Causes of Sleep Apnea in Children
The main cause of sleep apnea is hypertrophy of tonsils (throat) and/ or adenoids (nasopharynx). When the tissues are too large, they prevent the passage of air during breathing. A large tongue or deformity in the structure of the mouth or throat may obstruct the airway and affect breathing as well.
Obesity, asthma or allergic conditions are other risk factors. Obstructive sleep apnea syndrome can also be caused by upper respiratory tract infection or neuromuscular disease, or if the mandible is too short, or the jaw too narrow. Down’s syndrome or cerebral palsy may also be the underlying causes of sleep apnea in children.
Consequences of Sleep Apnea in Children
Besides poor performance in school and a constant feeling of irritation, sleep apnea has a few other consequences in children too.
- A break in the growth curve is sometimes noted.
- Risk of cardiovascular issues or lung problems, including hypertension
- Children may develop an increased resistance to insulin and experience daytime fatigue.
Sleep Apnea Treatment in Children
- Sleep apnea can be reversed by using a continuous pressure airway device (CPAP). The CPAP is in the form of a nasal mask to wear at night.
- Treatment is surgical when the syndrome is diagnosed due to enlarged tonsils.
- In case of obesity, a better lifestyle is recommended: weight loss and more regular physical activity.
- Orthodontic treatment by the pediatric dentistry department can help the child breathe better in case of jaw or mandible issues.
Managing Sleep Apnea
- In order to facilitate the passage of air when the child is sleeping, washing the nose well before sleeping can be a good preventive measure.
- In case of respiratory problems such as allergic rhinitis or asthma, appropriate care and medication is essential to improve the quality of sleep of the child.
A dental marketer at Michael G. Long DDS, Fresno, CA and a believer in holistic health, Grace lives by the rule that health and happiness go hand in hand. She writes on various dental topics focusing on healthy living and holistic health. When she’s not working or blogging, she enjoys spending her time with her family and volunteering at the local youth centers where she educates children about the importance of health and fitness.