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Could My Child Have Pediatric Sleep Apnea?

If your child is a restless sleeper or snores loudly even when they aren't sick, they may have sleep apnea.

Does your child snore loudly even when they don't have a cold? Does your child complain of headaches when they wake up or get very tired after regular activity? They may have sleep apnea.

Sleep apnea is when a person stops breathing during sleep. Episodes of sleep apnea can last from just a few seconds to a few minutes. A patient with sleep apnea can have upwards of 30 events per hour.

These episodes stop you from reaching the deep restorative level of sleep called REM. REM sleep is the stage in which you dream, and it is also when your body relaxes the most allowing itself to heal and replenish.

It's believed that as many as 4 percent of American children have sleep apnea, with most children falling between the ages of 2 and 8 years old.

There are three types of sleep apnea: obstructive, central, and complex (also called mixed) sleep apnea.

Obstructive sleep apnea is the most common type. The tissues of the soft palate and throat relax, blocking the airway.

Sometimes, the brain forgets to tell the lungs to breathe. This is called central sleep apnea and results in lapsed breaths. When the brain "remembers" to send the signal, breathing is resumed.

Rarely, patients have a mix of central and obstructive sleep apnea called complex sleep apnea.

Untreated sleep apnea in children can lead to learning and behavior issues, as well as physical delays and heart problems.

Risk Factors and Symptoms

Risk factors for pediatric sleep apnea include:

  • A family member with sleep apnea
  • Having Down syndrome, cerebral palsy, or sickle cell disease
  • Being overweight
  • A narrow airway
  • Enlarged tonsils

Symptoms of sleep apnea in kids can include:

  • Restless sleep and sleeping in unusual positions
  • Bedwetting when your child used to stay dry
  • Daytime sleepiness
  • Sleepwalking and/or night terrors
  • Hyperactivity or behavioral issues (not sitting still in class or following directions)
  • Snoring, snorting, and gasping when your child isn't sick
  • Waking up with a dry mouth, sore throat, or headache

How is Pediatric Sleep Apnea Diagnosed?

A diagnosis is made after a detailed exam and either an overnight sleep study or a home sleep test. The sleep study, or nocturnal polysomnography, involves going to a sleep center or hospital for several hours or overnight. A polysomnography technician runs special sensors to a cap that your child wears while they sleep. These sensors measure heart rate, lung activity, and brain wave patterns. The technician usually monitors the equipment in real-time as your child sleeps in the next room.

The home test involves a similar setup but is less involved. If the home test results are inconclusive, your child may still need to have a test done in a sleep center or hospital.

How Is Sleep Apnea in Children Treated?

When sleep apnea in children is mild, your child's care team might monitor the situation to see if they outgrow it.

Other treatment options include:

  • Inhaled nasal steroids may be prescribed for a while if the sleep apnea is a result of allergies or a similar issue
  • Tonsillectomy or adenoidectomy may be performed to open a child's airway
  • If your child is overweight, their doctor may recommend losing weight through increased physical activity and improved diet.

For other causes, your child's doctor may recommend continuous positive airway pressure (CPAP) therapy. Your child wears a mask that covers either their nose or nose and mouth while they sleep. The mask is connected to a machine that pumps air to open the airways.

For children who can't tolerate a CPAP machine, dental mouthpieces can be worn over the teeth. These devices keep the child's jaw in a specific position that allows their airway to stay open.

If your child is diagnosed with central sleep apnea, they may be able to use a device called a noninvasive positive pressure ventilation (NIPPV) device. They are programmed to a predetermined number of breaths per minute, which makes sure a set number of breaths are taken even without a signal to breathe from the brain.

If you suspect your child has sleep apnea, call your child's dentist or pediatrician to schedule an evaluation. If left untreated, sleep apnea could cause developmental delays or health conditions that could follow your child through life. Luckily, with a little diagnostic work, sleep apnea can be treated, and ever-evolving technology means your child can live a long, healthy life!

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