Pediatric obstructive sleep apnea (OSA) is a common, treatable condition. Obstructive sleep apnea causes breathing difficulties while sleeping. Some children do snore, only a small percentage (two percent) has obstructive sleep apnea.

Obstructive sleep apnea affects people of all ages. Children who have this condition can be harder to diagnose than older people. Children may snort or gasp while snoring and may “suck in” their chests. Their breathing starts and stops during sleep. This is caused by the throat narrowing or closing while they sleep. When breathing stops for short periods of time, it’s called apnea.

Children with pediatric obstructive sleep apnea have trouble sleeping at night. Because they’re tired, they often show behavioral problems during the day. If left undiagnosed, this condition can lead to problems at school and delayed growth. In extreme cases, it can cause heart failure. Heart failure happens when blood oxygen levels drop.

How Does Pediatric Obstructive Sleep Apnea Affect Children?

Muscles become more relaxed during sleep than during the waking hours. This includes the muscles used to breathe.

In some children with OSAS, the throat muscles relax so much that it interferes with breathing. Other children with OSAS have a very narrow throat passage that causes problems with breathing during sleep.

In some children with pediatric obstructive sleep apnea, the throat muscles relax so much that it affects breathing. Other children with this condition can have a very narrow throat passage that causes breathing problems during sleep.

When children with pediatric obstructive sleep apnea try to breathe, it’s like trying to slurp a drink through a floppy, wet paper straw. Children may make deep gasps as breathing starts. Each gasp may wake them up for few seconds.

What Are the Symptoms of Pediatric Obstructive Sleep Apnea?

Symptoms of pediatric obstructive sleep apnea can be hard to notice. They may include:

• Sleeping in odd positions, often with the head propped up or off the bed
• Snoring loudly and continuously
• Losing weight or not gaining weight
• Stopping breathing at night for a short period, followed by snorting and gasping or waking up
• Sweating heavily during sleep
• Acting out at home or school
• Sleeping problems (restlessness)
• Having trouble waking up even though the child should have had enough sleep
• Having headaches during the day, particularly in the morning
• Being irritable, aggressive and cranky
• Falling asleep or daydreaming in school or at home
• Wetting the bed at an unusual age
• Inability to concentrate at school
• Being hyperactive during the day

Pediatric obstructive sleep apnea can share symptoms with attention deficit hyperactivity disorder (ADHD). Because of this, some children with pediatric OSA are misdiagnosed as having ADHD. Some children may have both conditions. Pediatric obstructive sleep apnea can also sometimes worsen ADHD symptoms.

Are There Certain Factors that Increase Risk of Pediatric Obstructive Sleep Apnea?

• Enlarged tonsils and adenoids
• An abnormality in the face or jaw
• Down syndrome or other congenital abnormalities
• African American race
• Obesity
• Premature birth
• Family history of OSA
• Sedative medicines, which can promote snoring or slow breathing

How Do Doctors Diagnose Pediatric Obstructive Sleep Apnea?

Children and teens who snore should see a doctor to figure out if they have pediatric obstructive sleep apnea. In some cases, they may need to see a pediatric sleep specialist.

To diagnose this condition, a pediatric sleep specialist uses a test called polysomnography (PSG). This test records a child’s sleep activity for at least one night in a sleep lab. The study can determine the severity of the sleep apnea. It can also help doctors come up with the best treatment plan.

During the test, the specialist places sensors on the head and body to watch sleep patterns. The sensors record brain waves, leg and arm movements, muscle activity, heartbeat and breathing patterns. The sensors are not dangerous and are painless.

We encourage parents to stay with their children overnight in the sleep lab. This allows the parents to tell the staff if the study captured the child’s typical sleep and breathing patterns.

How Do Doctors Treat Pediatric Obstructive Sleep Apnea?

It’s important to treat pediatric obstructive sleep apnea as soon as possible. Treating it early can help the child maintain normal growth and development.

A child’s treatment plan depends on what’s causing the pediatric obstructive sleep apnea. Treatments may include:

• Surgery: If enlarged tonsils and adenoids are causing the condition, your doctor will recommend removing them. This surgery is called an adenoidectomy or tonsillectomy. Your doctor may also recommend other surgeries if the condition is caused by different structural issues.
• Continuous positive airway pressure (CPAP): A CPAP machine provides air pressure that keeps the throat from closing during sleep. Your child will wear a small mask over their nose during sleep. A CPAP machine may be helpful when surgery is not possible.
• Weight loss: If weight is the cause of pediatric OSA, your doctor may recommend a weight loss plan. The plan may include diet changes and exercise.
• Medications: Your doctor may recommend a nasal steroid or allergy medicine.

Your child may need to undergo a second PSG a few months after treating the pediatric obstructive sleep apnea. This second test can determine if the treatment or surgery worked. In some cases, the treatment can stop snoring but not cure pediatric OSA.