Childhood Sleep Apnea

Pediatric Sleep Apnea

Research studies conducted by the National Sleep Foundation estimate that between 1 and 5 percent of children have obstructive sleep apnea, many undiagnosed. In many instances, sleep apnea is overlooked or misdiagnosed in children because its symptoms often mimic other health conditions.

According to the American Sleep Apnea Association, sleep apnea symptoms in children often develop between the ages of 2 and 8 years old. Children with severe sleep apnea often develop symptoms between 3 and 5 years old, but the condition can also impact infants and older children.

While some children outgrow their obstructive sleep apnea, the majority do not and suffer from lifelong side effects caused by the condition.

When your child snores, it may seem cute, but snoring may also be a serious sign.

While snoring can happen for a variety of reasons, such as sinus congestion due to a cold, allergies or other illness, if you’re noticing snoring in your child several nights a week, it may be a sign of obstructive sleep apnea, a serious sleep disorder.

Obstructive sleep apnea (OSA) occurs when the soft tissue and muscles in the head and neck that help keep the upper airway open fall into the throat when your child is relaxed during sleep, causing airway obstruction and interruptions in breathing.

These interruptions can happen a dozen to hundreds of times a night depending on how severe your child’s sleep apnea is, and these interruptions can last a few seconds to a full minute.

The Signs of Pediatric Sleep Apnea

Other signs of obstructive sleep apnea in children include:

• Frequent snoring, snorts, choking or gasping for breath
• Heavy breathing while sleeping (hypopnea)
• Very restless sleep, tossing and turning, difficulty staying asleep, unusual sleep patterns
• Sleeping in unusual positions, such as with the head arched far back
• Bedwetting beyond potty-training years
• Daytime sleepiness
• Sleepwalking
• Night terrors or nightmares
• Difficulty staying awake during the day and daytime sleepiness due to poor sleep
• Irritability
• Learning difficulty, inability to focus
• Morning headaches
• Mouth breathing
• Smaller than peers, labeled as “failure to thrive”

In addition to these symptoms, sleep apnea can increase the risk of developing severe medical conditions such as high blood pressure, obesity, being overweight, diabetes and cardiovascular problems.

Oral Resting Posture

Proper oral posture is when the tongue is at rest on the roof of the mouth, with the teeth touching or slightly apart. Lips are closed without straining and the child is breathing through his or her nose. When this occurs, your child’s maximum airway potential and jaw growth potential are achieved, which means a significant reduction in the chance of developing sleep apnea. If your child does not have proper oral resting posture, it could be a risk factor for the sleep-breathing disorder.

Sarah’s parents knew it was important to start orthodontic treatment early. After receiving orthodontic care combined with myofunctional therapy, Sarah is now a thriving teenager who is happy with her smile.

Child Sleep Apnea and Behavioral Disorders

Sleep apnea and other sleep breathing disorders have also been linked to conditions such as ADD/ADHD, irritability and outbursts in children. Some research has shown that children with sleep apnea or those who experienced interrupted sleep from snoring had a 40 to 100 percent greater risk of developing ADHD-like symptoms than children who breathe well at night.

But why? Primarily because your child is tired! Despite getting a “full night’s sleep,” if your child experiences frequent sleep interruptions due to sleep apnea or sleep-disordered breathing, they’re not getting restful sleep. Also, consistently lower oxygen levels are unhealthy and negatively impact the brain, thus affecting behavior.

Lack of sleep has a significant impact on the development of children and affects them differently than adults. Instead of feeling sluggish and tired like sleep-deprived adults, children are more likely to exhibit behavioral problems such as mood swings, excitability, and difficulty sitting still, focusing and getting along with others. Unfortunately, some parents are not aware that their child’s symptoms are related to a sleep disorder.

The Causes of Child Sleep Apnea

Child sleep apnea can be caused by a range of issues, including airway problems such as a narrow airway, muscle weakness in the throat and mouth, and enlarged tonsils or adenoids.

Other contributors to sleep apnea in children include:

• Poor coordination of airway movements
• Chronic upper airway infections and sinus congestion
• Obesity
• Deviated septum or narrow nasal passages
• Enlarged nasal turbinates
• Tumors
• Craniofacial abnormalities
• Genetic disorders, such as Down syndrome and cerebral palsy
• Neuromuscular disorders

An underdeveloped mid-face caused by facial growth issues can also contribute to the development of sleep apnea. This situation occurs when the upper jaw does not fully develop due to environmental influence or poor oral habits such as extended thumb sucking or pacifier use. When the mid-face does not fully develop, the upper airway does not fully develop, potentially leading to airway obstruction and breathing interruptions.

Another cause of airway obstruction and sleep apnea is interruption in lower jaw development. When the lower jaw is set too far back, the tongue is also set far back, which means it can fall and block the airway during sleep.