If your child snores, it might not just be a minor annoyance. It could be a sign of a serious underlying condition. Pediatric obstructive sleep apnea (OSA) is a common yet often underdiagnosed disorder that can have significant long-term consequences for a child’s health and development.
Dr. Nikolaus Sneshkoff, an otolaryngologist at UCHealth Ear, Nose and Throat Clinic in Steamboat Springs, outlines what parents should know about sleep apnea in children.
What is sleep apnea, and what causes sleep apnea in kids?
“Pediatric obstructive sleep apnea is a condition where a child’s breathing is repeatedly interrupted during sleep,” Sneshkoff said. “This happens when the airway becomes blocked, usually by enlarged tonsils and adenoids.”
In adults, risks for sleep apnea include age and obesity, but in children, the main risk factors are having enlarged tonsils and adenoids, which are both part of the immune system.
“Tonsils and adenoids are just a small part of the immune system. Removing them does not impact the immune system due to its built-in redundancies,” Sneshkoff said. “Chronically diseased tonsils may actually be impairing the immune system, providing further rationale for removing them. The overall benefit of treating the sleep apnea significantly outweighs any impact on immunity.”
Other risk factors include genetic conditions, cerebral palsy, neuromuscular disorders, obesity and a family history of obstructive sleep apnea. Children who are Black, Hispanic or Native American are also at greater risk.
Between 1% and 5% of children are impacted by the condition.
“While that may seem like a small number, it translates to millions of children worldwide who are suffering from this condition, often without a proper diagnosis,” Sneshkoff said.
How do I know if my child has sleep apnea?
Loud, habitual snoring is a key indicator of the condition, but it’s not the only one. Parents should also watch for pauses in breathing, gasping or snorting sounds during sleep, restless sleep and sleeping in unusual positions.
The condition can impact a child during the day, resulting in behavioral problems, hyperactivity, difficulty concentrating in school and morning headaches.
While a formal sleep study is used to diagnose sleep apnea in adults, children can be diagnosed through a medical history and physical examination.
“We often use a tool called the Pediatric Sleep Questionnaire, which helps us assess a child’s risk for sleep-disordered breathing,” Sneshkoff said. “A score greater than eight indicates a high risk for OSA, prompting further evaluation and potential treatment.”
Are there risks to pediatric sleep apnea?
The repeated interruptions in breathing and lack of quality sleep can lead to a host of problems, such as failure to thrive, learning and behavioral issues that are sometimes misdiagnosed as ADHD, and even cardiovascular problems like high blood pressure.
“Growth hormone release occurs during restful sleep, so if a child isn’t getting good sleep, it could impact their growth,” he said.
What sleep apnea treatments are available for children?
The good news is that with proper diagnosis and treatment, many of these symptoms can be addressed.
“The most common and effective treatment is tonsillectomy and adenoidectomy,” Sneshkoff said. “This surgery removes the obstruction and allows the child to breathe freely during sleep.”
Through controlled ablation, low-temperature radiofrequency energy and saline are used to remove the tonsil and adenoid tissue. This technology typically results in decreased pain, less waiting and a faster recovery.
Sometimes, it can be helpful to use a CPAP machine, which delivers a steady stream of air to help keep the airway open during sleep. In cases related to obesity, lifestyle changes may make a difference.
“It is vital for parents to be aware of the signs of pediatric sleep apnea and speak with their pediatrician if they have any concerns,” Sneshkoff said. “Early diagnosis and treatment can make a world of difference in a child’s life, improving their health, behavior and overall well-being.”