Patient education: Sleep apnea in children (The Basics)

What is sleep apnea? — Sleep apnea is a condition that makes a person stop breathing for short periods while they are asleep. The most common type of sleep apnea is called "obstructive sleep apnea." In this type, the person stops breathing because their throat narrows or closes.

Both children and adults can have sleep apnea. In children, it often happens when the tonsils or adenoids are larger than normal. These are areas of soft tissue in the back of the throat (figure 1). If they are large, they can block the airway during sleep. Other conditions, including obesity and certain medical problems, also increase a child's risk of sleep apnea.

What are the symptoms of sleep apnea? — Sleep apnea causes symptoms both at night and during the day.

At night, your child might:

●Snore

●Breathe loudly or have trouble breathing

●Have pauses between breaths or suddenly gasp for breath

●Breathe through their mouth

●Seem restless or move around a lot

●Sweat a lot

●Wet the bed or wake up often to urinate

●Sleepwalk or have "night terrors"

During the day, your child might:

●Wake up with a headache

●Feel very tired

●Fall asleep at unusual times, like at school or on a short car ride

●Breathe through their mouth

●Have trouble focusing in school

●Act grumpy or irritated

Should my child see a doctor or nurse? — Yes. If you think your child might have sleep apnea, talk to their doctor. The doctor will do an exam and ask about your child's symptoms and sleep habits. They will probably also look into your child's mouth and throat.

The doctor might also suggest taking your child to see another doctor. This could be an expert in sleep problems or "ear, nose, and throat" medicine.

Is there a test for sleep apnea? — Yes. If a doctor suspects your child has sleep apnea, they might suggest a "sleep study." For this, your child will spend the night in a room called a "sleep lab." In the lab, your child will sleep in a bed while they are hooked up to different machines. The machines let the doctors monitor your child's heart rate, breathing, and other body functions.

In some cases, doctors will be able to tell that a child has sleep apnea without doing a sleep study.

How is sleep apnea in children treated? — There are 2 main treatments for sleep apnea in children:

●Surgery to remove the tonsils or adenoids – If your child's tonsils or adenoids are larger than usual, sleep apnea is often treated with surgery to remove them. This surgery is called "adenotonsillectomy."

●CPAP – Sleep apnea can also be treated with something called "continuous positive airway pressure" or "CPAP." This might be suggested if your child's tonsils and adenoids are normal size, if surgery is not an option, or if surgery did not help with symptoms. Other times, doctors suggest a few weeks of CPAP treatment before adenotonsillectomy.

For CPAP treatment, your child wears a mask over their nose during sleep. The mask connects to a machine that keeps air flowing and helps keep your child's airway open (figure 2).

If your child's doctor recommends a CPAP machine, try to be patient about helping your child learn how to use it. It can take time for a child to get used to wearing the mask and sleeping with the machine. Talk to your child's doctor or nurse if you are having trouble. They can give you tips on how to make the process easier, and can check the mask to make sure it is a good fit.

Some children need other treatments, too. For example, children with a narrow palate (roof of the mouth) might need to see an orthodontist. It sometimes helps to get a device that can widen the palate and make it easier to breathe during sleep. For children with seasonal allergies, doctors might suggest medicines to help with a stuffy nose.

Is there anything I can do on my own to help my child's sleep apnea? — Yes. In addition to the above treatments, there are some other things that might help. You can:

●Keep your home free of smoke – Do not smoke cigarettes in your home, or let others smoke. Smoke can make sleep apnea symptoms worse.

●Get treatment for asthma or allergies – If your child has asthma or seasonal allergies, make sure that they use any treatments the doctor has prescribed. Also, talk to the doctor or nurse about how to avoid "triggers." These are things that make the asthma or allergy symptoms worse. Triggers might include dust, mold, pets, or pollen.

●Help your child lose weight, if they are overweight – Being overweight or having obesity makes sleep apnea worse, so losing weight can help improve symptoms. Your child's doctor or nurse can give you tips on how to help your child make changes in order to lose weight safely. If your child is not overweight, losing weight will not help, and could even be harmful.

●Help your child avoid sleeping flat on their back – For older children who seem to have more symptoms when they sleep flat, changing position can sometimes help with breathing at night. You can try using blocks to raise the head of your child's bed. There are also special pillows and devices designed to help keep a person in one position. Talk to your child's doctor or nurse if you want to try this.

Can sleep apnea lead to other problems? — Yes. If it is not treated, sleep apnea can make a child very tired during the day. Over time, this can affect:

●Learning – This can include trouble thinking clearly, focusing, and keeping up in school.

●Mood and emotions – Children might act grumpy, irritable, or angry. They might also have depression or anxiety.

●Behavior – Some children have trouble controlling their behavior. They might act restless and have trouble sitting still.

●Growth – In severe cases, children with sleep apnea might not grow as quickly as they should.

●Heart function – Over time, sleep apnea can lead to heart problems. These can include a heartbeat that is faster than normal or high blood pressure.

Getting treatment for your child's sleep apnea can help your child feel better and prevent these problems.

More on this topic

Patient education: Sleep apnea in adults (The Basics)
Patient education: Daytime sleepiness (The Basics)
Patient education: What is a sleep study? (The Basics)
Patient education: Tonsillectomy and adenoidectomy in children (The Basics)
Patient education: Avoiding asthma triggers (The Basics)

Patient education: Sleep apnea in adults (Beyond the Basics)