😴Obstructive Sleep Apnea
Understanding sleep breathing disorders in children
What Is Obstructive Sleep Apnea?
Sleep apnea is when a person stops breathing during sleep. It usually happens because something obstructs, or blocks, the upper airway. This is called obstructive sleep apnea (OSA).
Obstructive sleep apnea (OSA) interrupts sleep and can make the body's oxygen levels fall or carbon dioxide levels rise. This can make kids miss out on healthy, restful sleep. Untreated obstructive sleep apnea can lead to learning, behavior, growth, and heart problems.
🔍What Causes Obstructive Sleep Apnea?
When we sleep, our muscles relax. This includes the muscles in the back of the throat that help keep the airway open. In obstructive sleep apnea, these muscles can relax too much and block the airway, making it hard to breathe.
Primary Causes:
- •Large tonsils or adenoids that block the airway during sleep
- •Muscles in the back of the throat relaxing too much
- •Large tongue that can fall back and block the airway
Risk Factors:
- •Family history of OSA
- •Being overweight
- •Medical conditions such as Down syndrome or cerebral palsy
- •Problems of the mouth, jaw, or throat that narrow the airway
⚠️What Are the Signs & Symptoms of Obstructive Sleep Apnea?
When breathing stops, oxygen levels in the body drop and carbon dioxide levels rise. This usually triggers the brain to wake us up to breathe. Most of the time, this happens quickly and we go right back to sleep without knowing we woke up.
This pattern can repeat itself all night in obstructive sleep apnea. Because of this, people who have it don't reach a deeper, more restful level of sleep.
Sleep-Related Signs:
- •Snoring, often with pauses, snorts, or gasps
- •Heavy breathing while sleeping
- •Very restless sleep and sleeping in unusual positions
- •Bedwetting (especially if a child had stayed dry at night)
- •Sleepwalking or night terrors
Daytime Symptoms:
- •Daytime sleepiness or behavior/learning problems
- •Hard time waking up in the morning
- •Tired or falling asleep during the day
- •Trouble paying attention or being hyperactive
- •Poor school performance
Important Note:
Because it's hard for them to get a good night's sleep, kids might be misdiagnosed with ADHD or learning problems. Teachers and others may think a child has these conditions when the real issue is obstructive sleep apnea.
🏥How Is Obstructive Sleep Apnea Diagnosed?
Talk to your doctor if your child snores regularly, is a restless sleeper, falls asleep during the day, or has other signs of sleep apnea. Your doctor might refer you to a sleep specialist or recommend a sleep study.
When to See a Doctor:
- •Snores regularly
- •Is a restless sleeper
- •Falls asleep during the day
- •Has other signs of sleep apnea
Sleep Study (Polysomnogram):
A sleep study can help doctors diagnose sleep apnea and other sleep disorders. Sleep studies are painless and risk-free, but kids usually need to spend the night in a hospital or sleep center.
During a sleep study, doctors check eye movements, heart rate, breathing patterns, brain waves, blood oxygen levels, carbon dioxide levels, snoring and other noises, and body movements and sleep positions.
💊How Is Obstructive Sleep Apnea Treated?
Treatment depends on the cause and severity of the sleep apnea. When obstructive sleep apnea is mild, doctors might check a child's sleep for a while to see if symptoms improve before deciding on treatment.
Mild Cases:
- •Monitoring sleep patterns
- •Nasal sprays or other medicines
- •Waiting to see if symptoms improve
Surgical Treatment:
When big tonsils cause sleep apnea, doctors will refer families to an ear, nose, and throat doctor (ENT). The ENT might recommend:
- •Removing the tonsils (tonsillectomy)
- •Removing large adenoids (adenoidectomy)
- •Removing both (adenotonsillectomy)
CPAP Therapy:
For other causes, a doctor may recommend continuous positive airway pressure (CPAP) therapy. In CPAP therapy, a person wears a mask during sleep. The mask may cover the nose only or the nose and mouth. It's connected to a machine that pumps air to open the airways.
When excess weight causes obstructive sleep apnea, it's important to work with a doctor on diet changes, exercise, and other safe ways to lose weight. These patients often need CPAP to help them breathe during sleep.
❓Frequently Asked Questions About Obstructive Sleep Apnea
What's the difference between sleep apnea and regular snoring?
Regular snoring is just noisy breathing during sleep. Sleep apnea involves actual pauses in breathing (apneas) that can last 10 seconds or longer. These pauses cause oxygen levels to drop and carbon dioxide levels to rise, triggering the brain to wake up to breathe. This pattern repeats throughout the night, preventing restful sleep.
Can sleep apnea affect my child's school performance?
Yes, absolutely. Because sleep apnea prevents children from reaching deep, restful sleep, they often have trouble paying attention, staying awake during the day, and performing well in school. Teachers may mistake sleep apnea symptoms for ADHD or learning problems. Treating sleep apnea can significantly improve academic performance.
What causes the airway to become blocked during sleep?
When we sleep, all our muscles relax, including those in the back of the throat that help keep the airway open. In sleep apnea, these muscles relax too much, allowing the airway to collapse. Large tonsils, adenoids, or a large tongue can also physically block the airway. Excess weight can contribute by adding pressure around the airway.
Is a sleep study scary or painful for children?
No, sleep studies are completely painless and risk-free. Children spend the night in a hospital or sleep center with sensors attached to their body to monitor breathing, heart rate, brain waves, and oxygen levels. It's like having a sleepover with medical monitoring. The staff is specially trained to work with children and make them feel comfortable.
Will removing tonsils and adenoids cure my child's sleep apnea?
For many children, yes. When large tonsils and adenoids are the primary cause of sleep apnea, removing them (tonsillectomy and adenoidectomy) is often very effective. However, some children may still need additional treatment, especially if they have other risk factors like obesity or structural airway problems.
What is CPAP therapy and how does it work?
CPAP (Continuous Positive Airway Pressure) therapy uses a machine that pumps air through a mask worn during sleep. The gentle air pressure keeps the airway open, preventing the breathing pauses that characterize sleep apnea. The mask can cover just the nose or both nose and mouth, and the machine is quiet and easy to use.
Can sleep apnea cause bedwetting in older children?
Yes, sleep apnea can cause bedwetting, especially in children who had previously stayed dry at night. The frequent awakenings and changes in oxygen levels can affect the body's ability to control bladder function during sleep. Treating the sleep apnea often resolves the bedwetting problem.
How can I tell if my child's snoring is a sign of sleep apnea?
Look for snoring that includes pauses, snorts, or gasps - these are signs of breathing interruptions. Other red flags include very restless sleep, unusual sleeping positions, daytime sleepiness, difficulty waking up, and behavioral or learning problems. If your child snores regularly and has any of these symptoms, talk to your doctor.
Can sleep apnea cause long-term health problems in children?
Yes, untreated sleep apnea can lead to serious health problems including learning difficulties, behavioral issues, growth problems, and heart problems. The repeated drops in oxygen levels and poor sleep quality can affect brain development, cardiovascular health, and overall well-being. Early diagnosis and treatment are important to prevent these complications.
What should I do if I suspect my child has sleep apnea?
Talk to your child's doctor about your concerns. Be prepared to describe your child's sleep patterns, snoring, and any daytime symptoms. Your doctor may refer you to a sleep specialist or recommend a sleep study. Keep a sleep diary for a week or two, noting snoring patterns, restlessness, and daytime behavior to help with the evaluation.