In pediatric obstructive sleep apnea, your child's breath is repeatedly partially or completely blocked during sleep. Their breathing will appear as events of reductions or pauses which typically increase during REM sleep. This condition is caused by a narrowing or blockage of the upper airway during sleep.
When a child's breathing is disrupted during sleep, due to sleep disorder breathing and the drop in oxygen levels, the brain signals to the body that the child is choking. This alert triggers the body into action causing blood pressure to rise and the child's sleep to be interrupted as the body tries to recover.
Sleep apnea in children differs from sleep apnea in adults. Daytime sleepiness tends to be more prevalent among adults, whereas behavioral problems are more prevalent among children.
According to the American Academy of Sleep Medicine, a child with sleep apnea may:
Experience prolonged pauses in their breathing lasting 20 seconds or longer at a time
Experience patterns of repeated pauses in their breathing lasting less than 20 seconds at a time
Experience related issues such as a slow heartbeat or low oxygen levels
It is common for infants to have some breathing instability when they sleep. Infants may experience this as part of their normal development. Infants can suffer from brief central apneas even if they are healthy. Isolated pauses like this may occur from time to time, especially when the child sighs or moves. These normal events last only a short time...typically no more than 20 seconds at a time.
It is rare for healthy infants to suffer from obstructive sleep apnea. Underdeveloped facial features, such as a small or pushed-back chin, structural airway abnormalities, and low tone may contribute to obstructive sleep apnea.
SIGNS OF SLEEP APNEA IN CHILDREN
While not all children exhibit these symptoms, the most commons signs of a sleep-related breathing issue or dysfunction in children include:
Extended pauses in breathing (lasting longer than 20 seconds)
Snorting, coughing, or choking while sleeping (often causing a child to tilt their head back to breathe)
Chronic mouth breathing when awake or asleep
Late age/stage bed wetting
Chronic sleep terrors
Poor weight gain in infants
Daytime sleepiness or trouble waking up in the evening after being in bed all night
Difficulty paying attention or ADHD diagnosis
Exhibiting behavioral problems
Depression or moodiness
The oxygen level in a child's blood may be lower due to sleep-disorder breathing. This is due to the fact that the condition can make it difficult for air and oxygen to flow into and out of the lungs. Children's lungs and hearts may be permanently damaged if this pattern continues.
Chronic sleep apnea can also lead to poor growth, lowering of the IQ by as much as 10 points, and facial development abnormalities.
WHAT IF YOU SUSPECT YOUR CHILD HAS A SLEEP ISSUE?
Sleep-disordered breathing isn't something your child will outgrow. As a chronic condition, it can progress over time and worsen, leading to other health problems.
If you have monitored your child and are noticing one or more of these symptoms, the first step in diagnosing sleep-disorder breathing in your child is to contact a pediatrician or dentist who specializes in the airways. Your pediatrician may refer your child to an airway-centric dentist, ENT, or accredited sleep center for further evaluation.
PREPARING FOR YOUR VISIT WITH YOUR CHILD'S PROVIDER
If you believe your child has an airway or sleep-disordered breathing issue, the first step is to make an appointment with your airway-centric dentist or pediatrician. Here are a few tips to keep in mind meeting with your child's provider:
Bring notes detailing the signs and symptoms you've identified that cause you to believe your child has an airway issue
Take time to write down your questions before your visit and bring them with you to the appointment so you can ensure you don't miss anything
Take notes during the visit --- writing down any diagnosis names, treatments, or new medications
Ask about any recommended tests or procedures --- make sure you understand why they are being recommended and ask questions so you know what to expect