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Recognizing Sleep Apnea in Children

By Emily Puro

Sleep specialists are on a mission to raise awareness about obstructive sleep apnea in children.

“It is under recognized and can lead to significant difficulties,” says Dr. Kyle Johnson, MD, co-director of the OHSU Sleep Disorders Program at Doernbecher Children’s Hospital.

One obstacle to diagnosing sleep apnea in children is that, while it causes brief arousals and sleep fragmentation during the night, kids and parents often are unaware it’s happening.

Symptoms of obstructive sleep apnea – which causes breathing to stop momentarily, leading to repeated arousals during the night – include snoring and pauses in breath, often followed by a snorting or gasping sound as breathing resumes. Not all children who snore have apnea, but it’s a common red flag.

“About 10 to 12 percent of kids snore and about three percent have apnea,” says Dr. Joshua Ramseyer, MD, director of the Legacy Sleep Disorders Center. “It’s becoming more common as the obesity epidemic gets worse.” Children who are significantly overweight have an increased risk of sleep apnea, as do children with certain medical conditions including Downs syndrome, cerebral palsy, and craniofacial (skull and face) abnormalities.

“Difficulties awakening in the morning, especially in school age children if they’re getting enough sleep, can be a red flag that something is going on to disrupt sleep during the night,” says Johnson. “Oftentimes that can be obstructive sleep apnea.”

If untreated, apnea can cause numerous problems for children, including an increased risk of depression, impeded physical growth, behavior problems and attention deficit hyperactivity symptoms.

“The end result of apnea in kids is often lack of attention, behavioral problems during the day and trouble learning,” says Ramseyer. “Once you treat the apnea, they tend to do very well. They often have a growth spurt, their behavioral disturbance improves, and they do better academically.”

If you notice any of the warning signs of apnea in your child, discuss it with your family’s pediatrician as soon as possible. The doctor will assess your child’s case and may refer him or her to a sleep specialist. Sleep apnea in typically developing children often is caused by adenoids or tonsils that are too large relative to the airway. In many cases, Johnson notes, removing the tonsils and/or adenoids cures the disorder without further treatment, leading to improved sleep and, therefore, improved daytime functioning.