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Can Children Have Sleep Apnea

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An Introduction To The Importance Of Sleep In Children And How To Help Them Sleep Better

Sleep is an essential building block for your child’s mental and physical health. But if you’re finding it impossible to help your toddler sleep, you’re not alone. The American Academy of Pediatrics estimates that sleep problems affect 25 to 50 percent of children and 40 percent of adolescents.

Understanding their sleep needs is the first step towards providing better sleep for your children. Through a combination of sleep hygiene, age-appropriate routines, and close attention to any sleep disorders, you can help your child get the rest they need to grow up strong and healthy.

Obstructive Sleep Apnea Is Common In Kids May Impact Blood Pressure And Heart Health

American Heart AssociationBlood PressureCardiologyHeartPediatrics

  • Children and adolescents can experience sleep-disordered breathing and obstructive sleep apnea, like adults. An estimated 1-6% of all children and adolescents have obstructive sleep apnea.
  • The sleep disruptions and pauses in breathing from sleep apnea may be linked to obesity, lipid disorders, elevated blood pressure, and changes in heart structure in kids.
  • Parents and health care professionals should consider testing for obstructive sleep apnea in children and teens who have symptoms such as habitual snoring, gasps, snorting, or labored breathing while sleeping, or with risk factors such as obesity and enlarged tonsils.

Obstructive sleep apnea, a form of sleep-disordered breathing, is common in children and adolescents and may be associated with elevated blood pressure and changes in heart structure, according to a new scientific statement from the American Heart Association, published today in the Journal of the American Heart Association. A scientific statement is an expert analysis of current research and may inform future guidelines.

  • Obstructive sleep apnea disrupts normal, restorative sleep, which can impact emotional health, as well as the immune, metabolic and cardiovascular systems in children and adolescents.
  • An estimated 1-6% of all children and adolescents have obstructive sleep apnea.
  • About 30-60% of adolescents who meet the criteria for obesity also have obstructive sleep apnea.

Obstructive Sleep Apnea Is Common In Kids And May Impact Blood Pressure Heart Health

American Heart Association
Children and adolescents can experience sleep-disordered breathing and obstructive sleep apnea, like adults. An estimated 1-6% of all children and adolescents have obstructive sleep apnea. The sleep disruptions and pauses in breathing from sleep apnea may be linked to obesity, lipid disorders, elevated blood pressure and changes in heart structure in kids.

Obstructive sleep apnea, a form of sleep-disordered breathing, is common in children and adolescents and may be associated with elevated blood pressure and changes in heart structure, according to a new scientific statement from the American Heart Association, published today in the Journal of the American Heart Association. A scientific statement is an expert analysis of current research and may inform future guidelines.

Sleep-disordered breathing is when someone experiences abnormal episodes of labored breathing, snoring and snoring sounds during sleep. It includes a spectrum of conditions from snoring to obstructive sleep apnea . OSA is associated with cardiovascular disease in adults, however, less is known about how the condition affects the immediate and long-term heart health of children and adolescents. The research reviewed for the statement reveals the following:

OSA may be present in children with the following symptoms:

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There Are A Number Of Theories That Could Explain The Link Between Smoking And Osa

A 2014 study published in the journal Chest reports that the following four mechanisms may explain the link between smoking and OSA: 

Changes in Sleep Architecture. Smoking disturbs sleep architecture by causing sleep deprivation and sleep interruptions. The decrease in sleep quality associated with smoking could be an intermediate step toward developing OSA. 

“Smoking interferes with your body’s natural sleep cycle and sleep architecture—circadian rhythm and sleep cycles,� Holly Schiff, PsyD, a licensed clinical psychologist at Jewish Family Services of Greenwich, tells WebMD Connect to Care. “Heavy smokers display the greatest risk for sleep-disordered breathing.�

Inflammation in the Airway Passage. “Smoking acts as an irritant that can provoke swelling in the nose and throat, which reduces the space left for airflow. This makes it harder to breathe as the tissue in your throat becomes more swollen and irritated—this can cause obstructive sleep apnea,� Schiff says.

Arousal Threshold Changes. Researchers hypothesize that cigarette smoking can affect your arousal threshold, or your propensity to awaken from sleep. 

Changes in the Neuromuscular Reflexes. Another theory is that the nicotine in cigarettes impairs muscular reflexes in the upper airway, leading to OSA. This theory is supported mainly by studies on animals, and additional human studies are required. 

What It Is How It Harms Chilrdrens’ Sleep And Health And How It Can Be Treated

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Sleep apnea is a condition in which breathing is interrupted during sleep. These pauses in breathing affect sleep quality and can lead to daytime sleepiness and behavior issues in children.

The two types of sleep apnea are obstructive sleep apnea and central sleep apnea . In OSA, a person tries to breathe but is unable to because of a constricted or blocked airway. In CSA, there is typically a lack of effort to inhale, so a person briefly stops taking breaths. Similar to adults, OSA is much more common in children than CSA.

Researchers estimate that between 1-5% of children have obstructive sleep apnea. Although studies have shown obstructive sleep apnea to be relatively rare in children, it is also commonly underdiagnosed.

Knowing the causes and symptoms of sleep apnea in children can help you determine when to see a pediatrician. There are tests available to diagnose sleep apnea and treatments that can help manage or resolve this condition.

Watch Out For Sleepwalking Bedwetting Snoring And Other Signs In Your Child

When referring to sleep apnea, you generally don’t think of a child as someone who is typically affected by the disorder. However, sleep apnea is increasingly diagnosed in children who are either sleep deprived or experience tell-tale signs of the disorder during or after sleep. Knowing the signs can help seek an early diagnosis and appropriate treatment.

If left untreated, sleep apnea can have significant consequences on a child’s growth, well-being, and behavior.

Up To 15 Percent Of Children Have Sleep Apnea Yet 90 Percent Go Undiagnosed

Children are grossly underdiagnosed for sleep disordered breathing , which includes obstructive sleep apnea , and the symptoms may be wrongly attributed to behavior issues, according to research in the Journal of the American Osteopathic Association.

Sleep apnea and related conditions can cause lasting damage to brain development during crucial years. As a result, children with undiagnosed SDB have been reported to use health care 226 percent more than the general population.

Up to 15 percent of children have some form of sleep disordered breathing. However, 90 percent go undiagnosed, often because symptoms are misattributed to psychological or emotional issues.

“Children who have behavior problems or are suspected to have ADHD might actually be suffering from a chronic lack of restorative sleep,” says John White, DDS, coauthor on this study.

Researchers explain that neurocognitive development, cellular regeneration, and tissue and bone growth all occur during the deep sleep stage. However, when breathing is obstructed in the upper airway, the brain switches back from deep to light sleep in order to resume normal breathing—barring the mind and body from critical restorative processes.

“A lot of airway problems come from poor jaw structure,” says White. “And the tongue is crucial in shaping the mouth, jaw and nasal cavity.”

Explore further

The Most Common Cause Of Osa In Children Is Enlarged Tonsils And Adenoids

The most common cause of blockage in a child’s airway that leads to OSA is enlarged tonsils and adenoids, according to Cedars-Sinai. These glands, which are located towards the back and sides of the throat, can grow too large or swell due to infection.

Additional risk factors for OSA in children include being overweight, having a tumor or growth that blocks the airway, or being born with certain conditions, such as Down syndrome or Pierre-Robin syndrome.

Exposure To Tobacco Smoke Can Be A Risk Factor For Osa In Children

A 2020 study published in Pediatrics International evaluated the correlations between exposure to cigarette smoke and the occurrence of sleep-disordered breathing in children. 

160 children between the ages of 6 to 18 years were enrolled in the study. The evaluation went on for almost 4 years, from 2012 to 2016. It found that OSA occurs more often in children who have been exposed to tobacco smoke. These children also exhibited a higher rate of other issues like tiredness, irritability, and concentration problems.

What Natural Treatments Are Available For Sleep Apnea In Children

The following natural treatments may help reduce obstructive sleep apnea in children. A child’s healthcare provider will be in the best position to discuss the risks and benefits of the natural treatment listed below:

  • Weight loss: In children with obesity and obstructive sleep apnea, weight loss can alleviate symptoms. A pediatrician can assist with healthy diet and exercise planning. A dietician or nutritionist can also help create a weight loss plan. However, weight loss can take time, and a child with severe symptoms may benefit from initiating treatment that provides relief more quickly.
  • Avoiding allergens: It may be helpful to avoid substances—such as pollen and mold—that can cause allergic rhinitis . Allergic rhinitis leads to congestion and airway restriction, which contribute to sleep apnea symptoms.
  • Nasal breathing retraining: Nasal breathing retraining is a type of physical therapy that aims to strengthen the tongue and surrounding muscles to help a child breathe effectively at night. It may help reduce symptoms, but data is limited.
  • Positional therapy: Positional therapy involves training a person to sleep in a different position. It may be used in children whose sleep apnea occurs only when they sleep on their back. Elevating the head of the bed can also help alleviate sleep apnea. However, limited information is available about the effectiveness of positional therapy in children.

Sleep Apnea Can Present Differently In Children Than In Adults

Symptoms of OSA vary slightly between children and adults. Some symptoms are the same, while others differ significantly. Common symptoms of OSA in adults include:

  • Fatigue
  • Suddenly waking up gasping or choking
  • Waking often to pee at night
  • High blood pressure
  • Gastroesophageal reflux disease

Certain symptoms of OSA in children can be less obvious and harder to connect to OSA. These symptoms include:

  • Drooling during sleep
  • Learning and behavior problems at school
  • Sluggishness or sleepiness, sometimes mistaken for laziness
  • Teeth grinding
  • Unusual sleeping positions

Tips On How To Make Sure Your Child Gets A Full Nights Sleep

Sleep needs change as your child grows older, but whether you’re dealing with a 2-year-old toddler or a stubborn teenager, research shows that a consistent bedtime routine is helpful for making sure your child gets enough sleep. Whatever activities you choose, try to do the same ones every day in the same order so your child knows what to expect.

A typical bedtime routine might include:

  • Putting on pajamas and brushing teeth
  • Reading a light book, singing a lullaby, or taking a bath
  • Picking a stuffed animal or security blanket for the night for toddlers

The best time to put your child to bed is when they’re sleepy, not when they’re already asleep. This helps them learn how to fall asleep on their own. If preschool children wake up in the middle of the night, walk them back to their bed. It’s best not to let infants sleep in your bed, as co-sleeping increases the risk of sudden infant death syndrome.

Risk Factors For Osa Are Different In Children And Adults

Kids can have Sleep Apnea

OSA occurs in both children and adults, but the risk factors change with age. In adults, “the main risk factors of sleep apnea include age , narrowed airways, obesity, alcohol consumption, sex , nasal congestion, and certain medical conditions, including high blood pressure and asthma,� Alex Savy, certified sleep science coach and founder of SleepingOcean, tells WebMD Connect to Care.

While weight and certain medical conditions in children are risk factors for OSA, children do not share the majority of the risk factors for OSA with adults.

Insulin Resistance Type 2 Diabetes And Metabolic Syndrome

The term “metabolic syndrome” has been used to describe the clustering of insulin resistance, dyslipidemia, hypertension, and obesity. Consensus criteria for the metabolic syndrome have yet to be defined in the pediatric age range . However, the risk of metabolic syndrome was nearly 50% in severely obese young children, and this risk increased with every 0.5-unit increment in BMI, when expressed as z score . In addition, it has become apparent that elevated fasting insulin levels and increased BMI during childhood are the strongest predictors of metabolic syndrome in adulthood .

Similar to obesity, OSA has been identified as an important risk factor for the metabolic syndrome in adult patients . In young children, both insulin resistance and altered lipidemia appear to be determined by the degree of obesity, and the contribution of OSA does not seem to be a major one . However, similar to adults, when obesity and OSA coincide in children the risk for metabolic disturbances is further increased . In a study of adolescents, the presence of OSA had a sixfold increase in the odds of metabolic syndrome compared with those without OSA . On a similar plane, obese children with OSA are at increased risk for development of nonalcoholic liver steatosis , a finding that is also present in rodents and adults with OSA .

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. So people who have it don’t reach a deeper, more restful level of sleep.

Signs of obstructive sleep apnea in kids include:

  • snoring, often with pauses, snorts, or gasps
  • heavy breathing while sleeping

Because it’s hard for them to get a good night’s sleep, kids might:

  • have a hard time waking up in the morning
  • be tired or fall asleep during the day
  • have trouble paying attention or be hyperactive

As a result, obstructive sleep apnea can hurt school performance. Teachers and others may think a child has ADHD or learning problems.

How Is Sleep Apnea Different Between Adults And Children

Sleep apnea leads to poor-quality sleep in all affected people, but the daytime symptoms can be different between adults and children. Adults are more likely to exhibit daytime sleepiness and fatigue, while children are more likely to show behavior issues such as difficulty concentrating and hyperactivity.

Additionally, sleep apnea is treated differently in children. In adults, the most common treatment is CPAP, while the most common treatment for children is surgery. Certain orthodontic treatments are only helpful in actively growing children and are not an option for adults with sleep apnea.

Untreated Osa Can Have Many Negative Impacts On Children

Children who have OSA are likely not getting the full amount of healthy and restful sleep that they need each night. They may experience health problems like growth and heart issues as a result, in addition to learning and behavior problems, according to Nemours Children’s Health System.

If you notice that your child is frequently tired or falling asleep during the day and having trouble paying attention or being hyperactive in class, it could be a sign of OSA. Sometimes, educators mistake symptoms of OSA as ADHD or other learning problems. Appropriate professional evaluation and testing will be needed for a proper diagnosis. 

What Are Signs And Symptoms Of Sleep Apnea In Children

Children with sleep apnea can exhibit the following signs and symptoms.  

At night or bedtime they may:

  • Snore loudly and regularly
  • Pause, gasp, snort, and stop breathing during sleep
  • Show actual difficulty in breathing 
  • Feel restless and sleep in strange positions
  • Experience night terrors with episodes of screaming, shouting, flailing, etc.
  • Sweat heavily 

During the day or in general, they may:

  • Show difficulty in waking up in the morning or ask for more time to sleep in 
  • Experience morning headaches
  • Be irritable, agitated, and cranky
  • Have social and behavioral problems at school
  • Be sleepy or fall asleep during the day
  • Breathe through the mouth regularly
  • Have a nasal voice  

Children with obstructive sleep apnea can exhibit symptoms similar to adults, like snoring and noisy breathing. It can also be that the disorder works differently across age groups, whereby adults can experience daytime sleepiness and childhood behavioral problems, according to the Mayo Clinic.

Bedwetting Could Be A Sign Of Obstructive Sleep Apnea

Bedwetting could be a symptom of OSA—especially if your child has previously been dry overnight. According to Cedars-Sinai, OSA is most commonly observed in children between the ages of 3 and 6. 

If your child is newly experiencing bedwetting overnight, be sure to include it in the list of symptoms that you share with your child’s healthcare provider.

What Are The Risk Factors For Sleep Apnea In Children

A child may have a higher risk of developing sleep apnea or have a high predisposition toward obstructive sleep apnea when the following factors are present:

  • Family history
  • Obesity 
  • Less muscle tone associated with neuromuscular diseases, Down syndrome, and cerebral palsy 
  • Genetic syndromes like Down syndrome and Prader-Willi syndrome  
  • Born preterm 

Low Birth Weight and Related Issues

Small for gestational age is a term used for babies who are smaller than those born with the usual number of weeks for pregnancy or due to problems that occur during pregnancy. 

A study in 2012 investigated the relationship between early childhood, sleep apnea, preterm birth, and SAG among children aged 2.5 to 6 years. It was found that:

  • Sleep apnea diagnosis is more prevalent in children born preterm
  • Children born small for gestational age did not show a high risk of sleep apnea.

On the subject of weight, being overweight can be a risk factor for sleep apnea, while being underweight can be a of the disorder. 

Slow-wave sleep or deep sleep is stage three of sleep when the body undergoes recuperation.   As part of the healing process, it secretes growth hormones. Sleep affects the release of GH, and disruptions caused by sleep apnea can adversely affect the child’s height and weight. 

What Are The Types Of Sleep Apnea Affecting Children

The Negative Impact Sleep Apnea Can Have on a Child

The three kinds of sleep apnea that affect children are as follows.  

1. Obstructive Sleep Apnea

This is the most common type of sleep apnea and sleep-disordered breathing .  Muscles, including those that support the head and neck, relax when one sleeps. The muscles can relax too much, causing the upper airway to collapse. That makes it difficult for air to pass through the lung, making breathing difficult. 

Enlarged tonsils and adenoids can cause this blockage, and this condition is most prevalent in preschoolers, according to the AASM. The event occurs in children two to six years old when the adenoids and tonsils are larger than the throat. 

What causes snoring?

The air that squeezes through the narrowed passage can produce snoring. When the passageway is completely blocked, the level of oxygen drops and the level of carbon dioxide increases. The brain alerts you to wake up briefly to breathe, thereby opening your airway and disrupting your sleep in turn. 

2. Central Sleep Apnea

This happens when the brain is unable to send signals to the muscles in charge of breathing. The underlying cause of CSA is the instability of the breathing control system due to serious diseases that involve the lower brainstem, where respiratory activities are produced and modulated. 


The main difference between the two apneas is:  



3. Complex Sleep Apnea Syndrome

Top 10 Signs And Symptoms Of Sleep Apnea In Children

October 18, 2017


As parents, you want the best for your child. One of your biggest fears is that something would come along to compromise the health of your child or place that health at risk. Sleep apnea is a condition that affects nearly three percent of children, according to a scholarly article appearing in the Korean Journal of Pediatrics.

That is why it is so important for you to be on the lookout for these:


What Is The Treatment For Sleep Apnea In Children

Related Reading

  • Adenotonsillectomy: Childhood sleep apnea caused by enlarged tonsils and adenoids may be cured by surgically removing the tonsils and adenoids.
  • Myofunctional therapy: Mouth and throat exercises, also known as “myofunctional therapy” or “oropharyngeal exercises,” have been shown to improve obstructive sleep apnea and snoring in children.
  • Orthodontics: Rapid maxillary expansion and mandibular advancement devices are orthodontic approaches that use dental hardware to create more space in the mouth and improve the flow of air through the airway.
  • CPAP: Also called continuous positive airway pressure, CPAP is a machine that continuously pumps air into the airway. CPAP users wear a mask attached to a pump while they are sleeping. Sleeping with a CPAP mask can be a difficult adjustment for children and may require behavioral support.
  • Treatment of allergies and sinus inflammation: Medications, such as a steroid nasal spray, saline nasal rinses, and/or other allergy medications, may be an option for children with mild sleep apnea symptoms. These medications can reduce airway constriction and poor tongue posture caused by constantly breathing through the mouth. Allergy treatment is often done in conjunction with other treatment options.

What Are The Symptoms Of Obstructive Sleep Apnoea

The first symptom most parents notice is snoring. Snoring is the sound made by the airway vibrating as it reopens after a partial collapse. Parents may also notice their child is sleeping in an unusual body position that may help them to breathe more easily. Recurrent breathing problems may also cause frequent, brief arousals throughout the night and this can make the child sleepy during the day.

Younger children who suffer from sleep deprivation may actually be hyperactive or aggressive, whereas older children may feel tired. A child with sleep apnoea may have difficulty concentrating or behave differently. They may awake from sleep feeling tired and unhappy, with a headache, or may refuse breakfast. Poor growth and weight gain, poor school performance, a lack of concentration and aggressive behaviour may also be seen.

Smoking Cessation May Improve The Symptoms Of Osa

The 2014 study published by Chest reports that giving up smoking can be beneficial for OSA patients. 

Nicotine withdrawal may cause symptoms similar to OSA, like sleeplessness and irritability, when smoking cessation first begins. However, data demonstrates that those who give up smoking on a long-term basis enjoy better sleep quality than those who do not. 

What Happens When Children Dont Get Enough Sleep

As every parent knows, a child that’s short on sleep can swing between being grumpy and hyperactive, with effects that can mimic ADHD. Sleepiness can also affect your child’s ability to pay attention, with ramifications for their performance in school. Even minimal sleep restriction can have effects on your child’s day-to-day life.

According to the American Academy of Pediatrics , a quarter of children under the age of 5 don’t get adequate sleep. This is worrying because poor sleep in early childhood has been linked to allergic rhinitis and problems with the immune system, as well as anxiety and depression. There is also emerging evidence that poor sleep in childhood may carry future cardiovascular risks in the form of obesity, diabetes, and high blood pressure.

In adolescents, inadequate sleep can have long-term effects on academic performance and mental health. The American Medical Association, the US Department of Health and Human Services, and the American Academy of Pediatrics consider chronic sleep loss in adolescents to be a public health problem. It is a risk factor for substance abuse and mental health problems, as well as more immediate problems such as car crashes and sports injuries.

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