Sleep Apnea in Children

The greatest challenge in generating awareness for sleep apnea is the common misconception and preconceived notion of how a typical patient looks like. When most people hear sleep apnea, they immediately think about middle weight obese men. While this image is not necessarily wrong, it does not accurately represent the full scale of things.

In reality there are actually many women who suffer from sleep apnea and even worse numerous children also suffer from sleep apnea. The sad news is that this misconception leads to such children being wrongly diagnosed with insomnia and other sleep disorders affiliated and associated with children. Just because children don’t fit the typical patient profile does not mean sleep apnea in kids should be ruled out. This article is a detailed coverage of sleep apnea in children to help clear out this popular misconception that sleep apnea is only reserved for overweight and middle aged men.

Let’s begin by looking at the prevalence and risks of undiagnosed and untreated sleep apnea in kids

Reliable statistics ascertain that the prevalence of sleep apnea in kids is significantly lower than in adults (sleep apnea prevalence in children is only at 5% as compared to the relatively high rate of 26% in adults between the ages of 30 and 70).

What are the risks of undiagnosed and untreated sleep apnea in kids?

If left untreated, sleep apnea in kids will not only make sleeping intolerable and uncomfortable for a child but will also cause other health complications such as adaptive, behavioral and learning problems. Some daytime symptoms of sleep apnea in kids will be very similar to the symptoms of ADHD –hyperactivity, learning disabilities and even poor academic performance.

Statistics actually prove that as many as 25% of kids diagnosed with ADHD actually suffer from sleep apnea and their misdiagnosed symptoms are a result of poor or fragmented sleep. A reliable extensive study also ascertained that kids with untreated sleep apnea are more likely to have grades lower than C despite consistent efforts to improve their academic performance. If the sleep apnea remains untreated for extended periods of time then such kids run the risk of developing debilitating health issues such as hypertension.

 

What are the symptoms of sleep apnea in children?

If you are worried that the cause of your child’s sleep troubles may be an indication of sleep apnea then there are symptoms you should keep an eye out for. Most of these symptoms will be clearly observed when the child in question is asleep while some will manifest during the day.

  • Consistent snoring; reliable research and statistics prove that 10% of children who snore consistently throughout the night suffer from sleep apnea
  • Breathing through the mouth during sleep; most kids who have enlarged adenoids caused by sleep apnea will tend to breath with their mouth open
  • Numerous breathing pauses when the kids is asleep
  • Daytime drowsiness, fatigue and sleepiness
  • Difficulty concentrating on normal day to day tasks
  • An extremely poor or shortened attention span
  • Consistent bed-wetting for no particular reason
  • Poor academic performance for unexplained reasons

Causes of Sleep apnea in kids

The causes of sleep apnea in kids can vary significantly from what cause sleep apnea in fully grown adults. While in adults the main contributing factors include age, weight and neck circumference. In kids the common cause of sleep apnea is enlarged adenoids or enlarged tonsils.

When adenoids or tonsils are enlarged, they cause breathing difficulties in the daytime while at night the muscles of the body tend to relax including those at the throat leading to blockage of the airway. The relaxation of the throat muscles is what causes the sleep apnea as there is restricted air flow particularly in the upper respiratory system.

Childhood obesity is also a risk factor for sleep apnea in kids the same way as in adults. This is because the more fatty the tissues in the throat are, the more likely breathing will be disrupted during sleep as the extra soft tissues (fat) in the throat will readily restrict the flow of air. However, research goes further to prove that obesity is only a risk factor in older children between the ages of 12 and 18 and not younger kids.

How can sleep apnea in children be accurately diagnosed?

It starts with scheduling an appointment for an overnight polysomnogram; this will help rule out sleep apnea. Pediatric polysomnograms are very similar to adult polysomnograms because both tests measure similar issues such as breathing, muscle movements, blood oxygen levels, brain activity and the heart rate. The only difference is that in kids, extra equipment is used to help monitor Carbon II Oxide (CO2).

To help ensure the child is comfortable and safe, parents are encouraged to accompany their kids and either sleep in the same room or in a separate bed. The diagnosis in a child varies significantly from that of an adult. Here is a comparison;

Index for sleep apnea diagnosis in adults

  • Mild- 5 to 14 episodes of interrupted incidences breathing per hour
  • Moderate- 15-30 episodes of interrupted incidences breathing per hour
  • Severe-30 or higher interrupted breathing incidences per hour
  • Index for positive diagnosis of sleep apnea in kids
  • Mild- 1 to 5 episodes of interrupted incidences breathing per hour
  • Moderate- 5 to 15episodes of interrupted incidences breathing per hour
  • Severe-15 or higher interrupted breathing incidences per hour

Viable treatment options for sleep apnea in children

  1. Since enlarged tonsils or adenoids are the most common cause of sleep apnea in kids, a surgery to remove these enlarged tissues will correct the symptoms in 90% of cases.
  2. For kids whose sleep apnea is a result of obesity, weight management and a change to lifestyle is the long term solution. These techniques include a reliable exercise regimen and healthy nutrition.
  3. In severe cases CPAP (continuous positive airway pressure) is recommended to treat sleep apnea.
  4. Oral or dental appliances are a recommended treatment regimen for older kids whose facial bone growth is complete.
  5. Medications for allergies are a viable treatment option if seasonal allergies aggravate the symptoms of sleep apnea in a child

Bottom-line

If your child has problems sleeping and the situation is only getting worse despite numerous diagnoses, it is time to consider the possibility that that child may be suffering from sleep apnea.

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