The image of a child, sleeping peacefully without a care, is a lovely one than many parents hold in their minds. In some cases, though, this peaceful scene is disrupted by sleep apnea. Sleep apnea occurs in approximately 5-10% of children and can affect everything from their behavior to their long-term health. If you think your child has sleep apnea, these are ten symptoms of sleep apnea in children to watch out for.
How do I know if my child has sleep apnea?
Sleep apnea is a disorder that usually affects adults. The two common types are obstructive sleep apnea and central sleep apnea. Obstructive sleep apnea occurs when the airway is blocked during sleep by the relaxed muscle of the tongue (or enlarged adenoids and tonsils in children). It’s the most common type of sleep apnea. Central sleep apnea occurs when the central nervous system malfunctions and essentially “forgets” to breathe.
The main risk factors for sleep apnea in children and toddlers are enlarged adenoids or tonsils. In some cases, obesity is a risk factor, but generally only for adolescents and young adults between the ages of 12 and 18.
Your doctor or a dentist can diagnose sleep apnea, but the gold standard of diagnostic tools is overnight polysomnography. During this exam, leads measure:
- Brain activity
- Breathing
- Muscle movements
- Heart rate
- Blood oxygen levels
In addition to these measurements, they’ll also record end tidal CO2 (how much carbon dioxide remains in the body at the end of exhalation).
Symptoms of sleep apnea in children and toddlers
For the smallest, squirmiest children, overnight polysomnography can be challenging.
In these cases, your doctor or dentist will ask about these ten signs of sleep apnea in your child to assist in diagnosing the condition.
1. Snoring
Snoring and sleep apnea are related. An estimated 10% of children who snore may also have sleep apnea.
While many children snore softly, this snoring is louder and more persistent and often interrupted by breathing pauses before gasping awake.
2. Mouth breathing
Enlarged adenoids or tonsils, one of the most common causes of sleep apnea in children, make nasal breathing difficult.
Additionally, smaller nasal passages (potentially due to high arched palate) also contribute to mouth breathing.
3. Breathing pauses during sleep
This symptom of sleep apnea is often the one that brings adults and children alike into a sleep disorder clinic.
Breathing pauses during sleep (the duration of the pause varies) and resumes with a sharp, gasping intake of breath. The sleeper may or may not wake during this. These pauses can occur up to 20 times an hour.
4. Daytime sleepiness
Daytime sleepiness (and accompanying irritability) is a common symptom. This sleepiness is chronic, not episodic.
5. Difficulty focusing
Children have challenges with focus for a variety of reasons, but severe issues can be a sign of sleep apnea in children and toddlers.
6. Behavioral issues and poor attention span
One study of children with behavioral issues such as ADHD and poor attention span found that these children were up to six times more likely to have sleep apnea.
The same study noted that when:
“[C]ompared to youth who never had sleep disordered breathing (SDB), children with sleep apnea were more likely to have parent-reported problems in the areas of hyperactivity, attention, disruptive behaviors, communication, social competency, and self-care.”
7. Poor performance at school
It stands to reason that children who are unable to focus, pay attention, and settle down into their day would have difficulties completing assignments.
The same study above found that children with sleep apnea were three times as likely to earn grades of “C” or lower across all subject areas.
8. Bedwetting
Sleep apnea can cause increased urine production at night. This can lead to bedwetting even in children who are completely potty-trained.
9. Poor oral health
There is a clear connection between dry mouth and cavities.
Because children and toddlers with sleep apnea often breathe through their mouth, their incidence of early childhood caries is higher than those who are able to breathe nasally.
10. Slow growth (failure to thrive)
Children with sleep apnea can produce lower levels of growth hormones and may experience slowed growth (or at an extreme, be diagnosed with failure to thrive).
Some children with sleep apnea are difficult to wake up and also experience headaches in the morning. Symptoms of sleep apnea in children are usually examined in combination. The more symptoms that are present, the higher likelihood that the child has sleep apnea.
Long-term health risks of sleep apnea in children include a risk of developing obesity, diabetes, cardiovascular issues, and other lung development issues. Treatment of sleep apnea is crucial.
How is sleep apnea treated in children?
Traditional treatment of sleep apnea includes the use of continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BPAP) machines. These utilize a small mask fitted over the nose and mouth to deliver a stream of oxygen to keep the airway open at night. For the smallest children, the discomfort of the mask and the noise of the machine can make complying with this treatment difficult.
For children whose sleep apnea is caused by enlarged adenoids or tonsils, removal of those usually “cures” the sleep apnea. In some cases, other surgeries in the areas of the nasal passages can help.
Finally, oral devices for sleep apnea can also help. These are custom-fitted by your dentist and fit into the mouth like an athletic mouthguard. The oral device keeps your child’s jaw and tongue in the proper position to open their airway. They can be refitted as needed until your child no longer experiences sleep disordered breathing.
AZ Dentist is a Phoenix area family dentist with experience in treating sleep apnea in children and toddlers. Our gentle approach can help your child get a good night’s sleep. Get in touch today!
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