Obstructive Sleep Apnea in Children
What is obstructive sleep apnea in children?
Obstructive sleep apnea is when a
child briefly stops breathing while sleeping. It happens because of a blockage in
upper airway. This is the passages through the nose and mouth to the windpipe and
The pause in breathing may occur many times in a night, disrupting the child’s sleep.
Most children will snore, but other symptoms such as wetting the bed or sleep walking
may also occur.
The condition is most commonly found in children ages 3 to 6.
What causes obstructive sleep apnea in a child?
The muscles in the head and neck help keep the upper airway open. When a child falls
asleep, these muscles tend to relax. That allows tissues to fold closer together.
If the airway is partially closed while awake, falling asleep may cause the passage
to close completely.
In children, the most common cause for such a blockage is enlarged tonsils and adenoids.
These glands are located at the back and to the sides of the throat. They may grow
too large. Or an infection may cause them to swell. They may then briefly block the
airway during sleep.
Obstructive sleep apnea may also be caused by:
A tumor or growth in the airway
Certain syndromes or birth defects, such as Down syndrome and Pierre-Robin syndrome
What are the symptoms of obstructive sleep apnea in a child?
Symptoms can occur a bit differently in each child. They can include:
Loud snoring or noisy breathing
(gasping or snorting) during sleep
Pauses in breathing, lasting usually a
few seconds up to a minute
A nasal voice
Restlessness during sleep
Too much daytime sleepiness or
Hyperactivity during the day
Sleep walking or night terrors
Need for a nap past the age of napping
The symptoms of obstructive sleep
apnea can be like other health conditions. Have your child see his or her healthcare
provider for a diagnosis.
How is obstructive sleep apnea diagnosed in a child?
The healthcare provider will ask about your child’s symptoms, health history, and
sleep patterns. He or she will give your child a physical exam. Your child may also
have a sleep study.
A sleep study is the best way to diagnose obstructive sleep apnea. But the test may
be hard to do with younger children or those who don’t want to cooperate. For the
study, your child may need to sleep in a special lab. While sleeping, he or she will
be connected to monitors that check:
Electrical activity of the heart
Oxygen and often carbon dioxide content in the blood
Movement of the chest and abdominal wall
Amount of air flowing through the nose and mouth
Your child’s healthcare provider
may refer your child to a sleep expert for more evaluation. Sometimes sleep apnea
testing may be done with a device used in your own home.
How is obstructive sleep apnea treated in a child?
Treatment will depend on your child’s symptoms, age, and general health. It will also
depend on how severe the condition is.
The treatment for obstructive sleep apnea is based on the cause. It may include:
Surgery to remove the enlarged tonsils
and adenoids. Your child’s healthcare provider will discuss the risks and benefits
Weight loss. If your child is
overweight, losing weight may ease symptoms.
Continuous positive airway pressure
(CPAP). While sleeping, your child wears a special mask that delivers a steady stream
of air to keep his or her airway open. Some children may have trouble getting used
Rapid maxillary expansion. This is a device put in place by an
orthodontist. The device widens the palate and nasal passages.
Inhaled steroids. These medicines may help children with mild
or moderate obstructive sleep apnea caused by enlarged tonsils.
Staying away from secondhand smoke,
indoor pollutants, and allergens. This is important for children who also have nasal
What are possible complications of obstructive sleep apnea in a child?
Sometimes the condition can cause your child to have less oxygen in
the blood than normal. This is because the condition can make it hard for air and
to flow in and out of the lungs. If this pattern continues, your child's lungs and
may have permanent damage. Chronic sleep apnea can also lead to poor growth and
Key points about obstructive sleep apnea in children
Obstructive sleep apnea is when a child briefly stops breathing while sleeping. It
often occurs because of a blockage in the airway.
The most common cause is large tonsils and adenoids in the upper airway.
Loud snoring or noisy breathing while sleeping is a main symptom. Your child may also
be irritable, sleepy, or hyperactive during the day.
A sleep study is the best way to diagnose the condition.
If your child has large tonsils and adenoids, having them surgically removed may help.
Tips to help you get the most from a visit to your child’s healthcare provider:
Know the reason for the visit and what you want to happen.
Before your visit, write down questions you want answered.
At the visit, write down the name of a new diagnosis, and any new medicines, treatments,
or tests. Also write down any new instructions your provider gives you for your child.
Know why a new medicine or treatment is prescribed and how it will help your child.
Also know what the side effects are.
Ask if your child’s condition can be treated in other ways.
Know why a test or procedure is recommended and what the results could mean.
Know what to expect if your child does not take the medicine or have the test or procedure.
If your child has a follow-up appointment, write down the date, time, and purpose
for that visit.
Know how you can contact your child’s provider after office hours. This is important
if your child becomes ill and you have questions or need advice.