What is obstructive sleep apnea?
Obstructive sleep apnea (OSA) is a condition in which there are
brief pauses in your child’s breathing pattern during sleep. Breathing usually
stops because there is a blockage – or an "obstruction" – in the airway. OSA
occurs in many children, and is most commonly seen in children between the ages
of 2 and 6 years of age.
Sleep apnea results in many brief awakenings from sleep when the
brain senses changes in the oxygen or carbon dioxide in the body and send
signals to the lungs to try to breathe. It is like hearing the telephone ring
once in your sleep and then stop. You may not even get up to reach for the phone
but your sleep is interrupted briefly. Now imagine this happening over and over
again throughout the night! Although your child may not be aware he or she is
waking up, these interruptions in sleep can lead to daytime problems.
What causes sleep apnea?
The most common cause of sleep apnea in children is enlarged
tonsils and adenoids (large relative to the child’s airway) that block the
airway and breathing during sleep. During the daytime, muscles in the head and
neck more easily keep the airway passages open. During sleep, muscle tone
decreases, allowing tissue to come closer together and these large tonsils and
adenoids tend to block the airway for periods of time. Other tissues in the
nose, neck and the tongue also contribute.
Other causes of OSA include:
- Obesity
- Narrow facial bone structure
- Retrognathia (small jaw)
- History of cleft palate or pharyngeal flap surgery
- Low muscle tone (hypotonia as in neuromuscular diseases)
- High muscle tone (as in cerebral palsy)
- Tumor or growth in the airway (rare)
Sleep apnea also occurs more commonly in children with Down
syndrome. Other children who may be at greater risk for developing OSA include
those with nasal allergies, asthma, reflux, and frequent upper airway infections.
What are the signs and symptoms of obstructive sleep apnea?
- Loud or noisy breathing, snoring, or mouth breathing during sleep
- Brief pauses in breathing during sleep or difficulty breathing during sleep
- Restless sleep (ie, lots of tossing and turning)
- Sweating heavily during sleep
- Bed wetting
- Sleeping in odd positions
- Inattentiveness and lack of focus at school
- Excessive daytime sleepiness (eg, child falls asleep in school)
- Poor academic performance
- Irritable mood, aggressiveness, other behavioral problems
- Morning headaches
How is obstructive sleep apnea diagnosed?
Once your child’s physician suspects sleep apnea, he or she may
recommend that your child be seen by a sleep specialist. In addition to a
complete medical history and physical exam, a sleep specialist may conduct the
following tests to determine if your child has sleep apnea: