Ask any new parent to name the hardest thing about raising their child, and one answer rises to the top: bedtime. Sleep is an essential component of health in children. What happens when one cranky bedtime turns into weeks (or months) of sleepless nights, though? Sleep apnea in toddlers could actually have serious lasting effects on your toddler’s health. Here’s what you should know.
Is sleep apnea in toddlers dangerous?
As with adults, sleep apnea in toddlers can be very dangerous. Effects can range from acutely mild to serious in the long-term.
The most common health risks for sleep apnea in toddlers include the following:
- Increased hyperactivity and inattention
- Difficulties in neurocognitive function
- Poor school performance
- Lower IQ scores
- Future obesity
Let’s look at each of these in more detail.
Increased hyperactivity and inattention
Toddlers and school-aged children are diagnosed in increasing numbers with ADD (inattention) and ADHD (inattention with hyperactivity).
Toddlers with chronic sleep disturbances tend to be diagnosed with either of these conditions at much higher rates than those with regular sleep patterns.
Difficulties in neurocognitive function
Toddlers with sleep apnea may experience challenges with their neurocognitive function. Simply put, without adequate sleep, a toddler’s brain does not function as well.
Future poor school performance
It makes sense. Sleepy children who are unable to concentrate (or stay awake) at school do poorly when compared to children without sleep disturbances.
Lower IQ scores
Multiple studies of intelligence have found that children with sleep disordered breathing of any kind (including sleep apnea) consistently score lower on intelligence measures. Children who rank in the lower 10% of their class are six to nine times more likely to have sleep apnea.
And these effects are likely to carry into adolescence. One study of snoring (a risk factor for sleep apnea) found that children who snored loudly and often during childhood were at an increased risk of poor performance as teens. This was true even if the snoring resolves. Sleep apnea during the developing toddler years may place growing children at a “learning debt” that is difficult to overcome.
Sleep apnea in toddlers is highly predictive of adult obesity. Both of these conditions – obesity and sleep apnea – are also associated with an increased risk of hypertension and cardiovascular issues.
How do I know if my toddler has sleep apnea?
Many of the symptoms of pediatric obstructive sleep apnea are the same for toddlers as they are for adults. These include:
- Mouth breathing
- Pauses in breathing during sleep
- Daytime grogginess
There are other, more troubling symptoms specific to toddlers. Behavioral and developmental problems such as ADHD and slowed development have been associated with sleep apnea in toddlers and grade school-aged children. In some cases, a diagnosis of failure to thrive may actually be sleep apnea.
It is hard to know exactly how many children suffer from sleep apnea. Estimates place the incidence at between one and 10%. Because sleep apnea in toddlers can masquerade as ADD or ADHD (or other seemingly unrelated behavioral issues), getting a diagnosis is crucial for proper treatment.
The traditional diagnostic tool for sleep apnea is polysomnography at a sleep lab. The patient is hooked to wires, which are then connected to a machine. This measures things like respiration and heart rate. For toddlers, though, polysomnography might be too scary to get an accurate result. In this case, an in-home sleep apnea test works well. You can administer the tests at home and then send them to your doctor to interpret.
Can a child grow out of sleep apnea?
There is no simple answer to this question. In some cases, a toddler diagnosed with sleep apnea may appear to outgrow it, only to have it resurface in their teens. Children with chronic sinus issues or obesity may see a decrease in symptoms when these conditions improve.
Each child (and their growth patterns) is so different that there is no one answer to this question.
How to treat sleep apnea in toddlers
Knowing that chronic poor sleep can have such adverse effects on your child’s growth and development is scary, but there is good news. The cognitive and behavioral issues above are often completely reversible with successful treatment for sleep apnea.
Early intervention is key.
If your toddler has sleep apnea, treatment is crucial. For some, minor sleep apnea means simply monitoring the situation and assessing any underlying factors that may cause symptoms. If your child has a stuffy nose or is carrying extra weight, clearing the sinuses and managing weight might resolve symptoms. Sometimes a nasal decongestant can help clear the nose for better sleep. Allergy medications during the appropriate seasons may also help.
Some older children may be prescribed a continuous positive airway pressure (CPAP) machine, but for toddlers, this treatment is often impossible. The mask (and machine itself) can be scary, and toddlers may refuse to comply with treatment. This results in not getting treatment at all.
In other cases, enlarged tonsils and adenoids may be the culprits. Surgery is an option only after other conservative treatments have failed and untreated sleep apnea would cause more harm than surgery.
Another good option for treating sleep apnea in toddlers is a sleep apnea dental device. These devices are custom-fitted to your child and adjusted gradually to relieve their sleep apnea symptoms.