In sleep apnea, breathing is repeatedly interrupted. In children, these pauses in breathing can impact sleep quality and lead to daytime drowsiness and behavioral problems.
Obstructive sleep apnea (OSA) and central sleep apnea are the two kinds of sleep apnea (CSA). OSA occurs when a person’s airway becomes restricted or clogged, making it impossible for them to breathe. CSA is characterized by a lack of effort put forward during inhalation, resulting in a momentary pause in breathing. OSA is far more common in children than CSA, as it is in adults.
Between 1 and 5 percent of children are thought to be affected by sleep apnea. Obstructive sleep apnea in children is uncommon, according to research, but it is frequently misdiagnosed.
Sleep apnea in children can be diagnosed more easily if you are aware of the causes and symptoms. Sleep apnea can be diagnosed and treated using a variety of methods, including testing and medications.
What Causes Obstructive Sleep Apnea in Children?
In children, obstructive sleep apnea can be caused by a variety of factors.
- Enlarged tonsils and adenoids: Tonsil and adenoid hypertrophy is a well-established risk factor for juvenile obstructive pulmonary disease (OSA). Anti-inflammatory glands such as the tonsils and adenoids can be found in the throat. Genetics, recurrent infections, or inflammation can all contribute to enlarged tonsils and adenoids. Having swollen these glands makes it more difficult to breathe while you sleep since they narrow the airway.
- Childhood obesity: Obesity can also induce obstructive sleep apnea (OSA) in youngsters. 60% of obese children have a condition called obstructive sleep apnoea.
- Other risk factors: A tiny or overbite jaw, the use of sedatives or opioids, and the weakening of the tongue and throat muscles owing to diseases like Down syndrome or cerebral palsy are also potential causes of OSA. Childhood OSA is also linked to nasal allergies, exposure to adults who smoke, and a family history of obstructive sleep apnea.
What Causes Central Sleep Apnea in Children?
In children, central sleep apnea can be caused by a variety of factors. A few apneic episodes during the night are regarded as usual, and should not be considered abnormal. Congenital central hypoventilation syndrome has been linked to central sleep apnea in children. In other cases, it might be caused by health issues that affect the central nervous system, which regulates breathing in youngsters.
What Are the Symptoms of Sleep Apnea?
Obstructive sleep apnea is associated with snoring. Sleep apnea affects just a small percentage of children who snore and snore loudly. Symptoms of sleep apnea can only be diagnosed by a doctor.
In addition to snoring, children with sleep apnea may also have the following signs and symptoms:
- During sleep, mouth breathing is used.
- Choking or coughing fits.
- Sweating during the night.
- The ramblings of a tired mind.
- Fear of the dark.
Sleep apnea also has negative effects on a person’s health while they are awake. Included on this list:
- A feeling of drowsiness during the day.
- I’m having trouble focusing.
- Attention deficit hyperactivity disorder (ADHD) mimics a variety of behavioral issues, including hyperactivity, rebelliousness, and impulsiveness.
- Anxiety at the start of the day.
- I’m in a foul temper.
- Controlling one’s emotions is a challenge.
How Is Sleep Apnea Diagnosed in Children?
It is important to get as much information as possible regarding a child’s sleep habits and any daytime and nighttime symptoms from the child’s parent or guardian. Additionally, a physical examination of the child’s mouth, neck, and throat may be conducted by the doctor to look for physical traits that raise the risk of sleep apnea (such as enlarged tonsils and adenoids).
For those whose results show that more testing is needed, the doctor might recommend an overnight sleep study called polysomnography at a sleep clinic. In polysomnography, specific bodily functions are measured while the subject is asleep. It is completely non-invasive and painless. Testing for sleep apnea using polysomnography, the gold standard, is the only way to be sure.
Based on guidelines from the American Academy of Pediatrics and the American Academy of Sleep Medicine, home sleep studies are typically not advised for children.
What Is the Treatment for Sleep Apnea in Children?
Depending on the underlying reason and degree of symptoms, treatment options for childhood sleep apnea might vary widely.
- Adenotonsillectomy: Surgical removal of the tonsils and adenoids can cure childhood sleep apnea caused by swollen tonsils and adenoids.
- Myofunctional therapy: Oropharyngeal exercises, also known as “myofunctional therapy,” has been demonstrated to help children with snoring and obstructive sleep apnea have better sleep.
- Orthodontics: Orthodontic methods that use dental hardware to expand the mouth and enhance airflow through the airway are known as rapid maxillary expansion and mandibular advancement devices.
- CPAP: This equipment, often known as CPAP (continuous positive airway pressure), works by continually pumping air into the user’s airway as they sleep. CPAP patients use a mask connected to a pump while they sleep. Sleeping with a CPAP mask may necessitate behavioral help for youngsters.
- Treatment of allergies and sinus inflammation: A steroid nasal spray, saline nasal rinses, and/or other allergy drugs may be prescribed to children with mild sleep apnea symptoms. As a result of repeatedly inhaling through the mouth, the airways and tongue get constricted, resulting in a bad posture. Treatment for allergies is frequently used in conjunction with other therapies.
Another option is to keep a close eye on children who show no signs of illness. During the period of “watchful waiting,” a patient may receive assistance in the form of sleep hygiene instruction, symptom monitoring, and regular checkups with their doctor.
What Natural Treatments Are Available For Sleep Apnea in Children?
In children, the following natural remedies may alleviate obstructive sleep apnea (OSA). It is advisable to examine the dangers and advantages of the following natural treatments with your child’s doctor.
- Weight loss: Obesity and obstructive sleep apnea in children can be treated with weight loss. A doctor can offer advice on how to maintain a healthy weight and get regular exercise. A nutritionist or dietician can also assist in the creation of a weight-loss strategy. When a child’s symptoms are so severe that he or she needs immediate therapy, weight loss may not be enough.
- Avoiding allergens: If you suffer from allergic rhinitis, it may be beneficial to avoid pollen and mold (an allergic reaction of the nasal passages). Allergic rhinitis causes airway obstruction and congestion, which contributes to the symptoms of sleep apnea.
- Nasal breathing retraining: When a child has difficulty breathing at night, they may need to undergo nasal breathing retraining (also known as myofunctional therapy), which is a form of physical therapy. Symptoms may be alleviated, although research is insufficient.
- Positional therapy: Training one’s body to sleep in a new position is the goal of positioning therapy. If your child has sleep apneic episodes when they sleep on their back, you may want to consider using this device. Sleep apnea sufferers may find that raising the head of the bed reduces their symptoms. Positional therapy’s effectiveness on children, on the other hand, remains obscure.
How Is Sleep Apnea Different Between Adults and Children?
All those affected by sleep apnea suffer from sleep deprivation, although the daytime symptoms might vary from person to person and from child to child. Daytime sleepiness and weariness are more common in adults, whereas youngsters are more prone to display behavioral difficulties such as inability to concentrate and hyperactivity.
Additionally, the treatment of sleep apnea in children is different. CPAP is the most common treatment for adults with sleep apnea, while surgery is the most common procedure for children. The only people who can benefit from some orthodontic treatments are still-growing youngsters, so adults with sleep apnea are out of luck.
When Should We See a Doctor?
If you notice any atypical sleep issues, it’s best to see a doctor. In addition, youngsters who aren’t getting enough sleep may have difficulty concentrating, be irritable, or exhibit poor self-control. You may want to question your child’s doctor if a sleep ailment such as sleep apnea could be to blame for their behavioral issues.
Symptoms of sleep apnea in children
Other than snoring differences, the symptoms of obstructive and central apnea may be similar.
Sleep apnea symptoms in children include:
- snoring that is too loud to be ignored.
- being awakened by a cough or choking fit.
- breathing pauses.
- Inhaling and exhaling through the nose.
- recurring nightmares that keep you awake at night.
- The practice of sleeping in an unusual position.
Although sleep apnea is mostly a nighttime problem, its symptoms can be seen throughout the day as well. Anxiety, exhaustion, and difficulties falling asleep or getting up in the morning can all occur during the day if your child suffers from this sleep condition.
Some children with sleep apnea, particularly those with central apnea, do not snort. In this age range, the only evidence of sleep apnea may be uncomfortable or disturbed sleep as the only symptom.
Outlook for children with sleep apnea
It is possible to treat sleep apnea in children with some success.
Obstructive sleep apnea symptoms are reduced in up to 79% of children who have their tonsils and adenoids surgically removed, according to a review of research published in 2018. More severe apnea previous to surgery, age, and obesity were all risk factors for post-surgical symptoms in children.
Symptoms following surgery were also more common in Black youngsters in a 2013 random experiment. They did, however, have more severe apnea.
Patients’ symptoms are often alleviated by reducing their weight, using a CPAP machine, or wearing an oral appliance.
You and your child’s quality of life may suffer if sleep apnea is not treated. They may have a hard time staying focused in class. This illness, if it persists into adulthood, could put them at risk for serious health problems like heart disease or stroke.
Consult your child’s physician if you notice any of the following symptoms in your child:
- snoring that is too loud to be ignored.
- breathing pauses while they are sleeping.
- extreme exhaustion during the day.