Sleep apnea is a condition that affects a child's breathing while they are sleeping. Learn about the causes, symptoms and diagnosis.
Key points
Obstructive sleep apnea (OSA) occurs when a child’s airway becomes blocked while they are sleeping.
Common causes of sleep apnea in children are larger than normal tonsils or enlarged adenoids. Other causes include excess body weight and weakness in the muscles involved in breathing.
Nighttime symptoms of sleep apnea include snoring, breathing through the mouth and restless sleeping. Daytime symptoms include drowsiness, poor concentration and lack of energy.
Sleep apnea is diagnosed through a sleep study. Treatment can include surgery, a weight loss program or positive airway pressure.
Introduction
What is obstructive sleep apnea?
Paediatric obstructive sleep apnea (OSA), or sleep apnea, happens when a child's airway becomes partially or completely blocked while they are sleeping. The blockage of the airway can cause snoring, gasping, pauses in breathing and changes in the body's oxygen levels.
Sleep apnea affects one to five children in 100. If your child snores, for example, it may not always be due to sleep apnea.
Signs and symptoms
Nighttime symptoms of obstructive sleep apnea
If your child has obstructive sleep apnea, you will recognize a number of signs while you watch them sleep. These may include:
snoring — this may be continuous or with pauses or may only occur in certain body positions (for example while your child lies flat on the back) or during certain periods of sleep
When your child is experiencing restless sleep, they may be turning from side to side, jerking their legs or sitting up in an attempt to breathe better while still asleep.
Daytime symptoms of obstructive sleep apnea
Because your child is waking up many times during the night, they are not rested in the morning. As a result, they may have the following symptoms during the day:
sleepiness, especially at school or during quiet activities
learning difficulties
poor concentration for homework
lack of energy for sports and hobbies
irritability, hyperactivity, impulsivity or aggression.
Causes, risk factors and prevalence
What causes obstructive sleep apnea?
Common causes of obstructive sleep apnea in children are larger than normal
tonsils or
enlarged adenoids at the back of the nasal passages (the airways behind the nose). Obstructive sleep apnea due to enlarged tonsils or adenoids commonly occurs in children aged two to eight years.
Other possible causes of obstructive sleep apnea include:
weakness in the muscles involved in breathing, such as the diaphragm and muscles in the neck and around the ribs, such as in a neuromuscular disease (a disease that affects the nerves and muscles)
the shape and size of a child's skull and jaw
other health conditions that affect your child's airways or ability to breathe.
Diagnosis
How is sleep apnea diagnosed in children?
Your health-care provider will usually refer your child to a sleep medicine specialist in the hospital. The sleep medicine specialist will meet with you to see if your child's symptoms need a closer look. If so, your child will come back to the hospital for a
sleep study.
This study is an overnight sleep "test" during which your child will have wires attached to their skin with paste and child-friendly tape. The wires do not hurt and are connected to a machine. As your child sleeps, the machine will record their oxygen level, breathing pattern, heart beat and sleep pattern. A sleep technologist will also observe your child during the study.
Once the sleep study is over, a sleep respiratory therapist will study the recordings on the machine to identify the type of sleep problem your child has and how serious it is.
If your child has other medical conditions that may affect or be affected by obstructive sleep apnea, the sleep medicine team may refer them to other specialists and clinics to make sure they get the best treatment.
Complications
Why is it important to diagnose and treat obstructive sleep apnea?
It is important to diagnose obstructive sleep apnea early. If it is not treated, it can be linked to other health issues, such as:
cardiovascular complications, including high
blood pressure
not growing well or gaining weight
learning difficulties at school
behavioural problems such as hyperactivity or inattention.
At SickKids
At SickKids
The sleep medicine team at SickKids includes:
a respirologist — a doctor specially trained to diagnose and manage sleep disorders in children