Childhood Sleep Apnea

Sleep apnea is a disorder characterized by abnormal breathing patterns during sleep. It occurs when airflow is repeatedly interrupted despite ongoing breathing efforts. In children, sleep apnea can significantly impact growth, cognitive development, and behavior, making early detection and treatment critical.

Sleep-disordered breathing in children encompasses a spectrum of conditions ranging from primary snoring to more severe forms like obstructive sleep apnea and central sleep apnea. These conditions can appear at any age, including infancy, and are most prevalent between ages 2 and 8.

1. Obstructive Sleep Apnea (OSA)

Obstructive sleep apnea is the most common type in children. It occurs when the upper airway becomes partially or completely blocked during sleep, despite continued respiratory effort. This blockage leads to disrupted sleep, intermittent oxygen desaturation, and increased carbon dioxide levels.

• Causes: Enlarged tonsils or adenoids are the most frequent causes in children. Obesity, craniofacial abnormalities, and neuromuscular disorders may also contribute.
• Symptoms: Snoring, restless sleep, pauses in breathing, daytime sleepiness or hyperactivity, and behavioral issues.
• Impact: If untreated, OSA may lead to growth delays, poor academic performance, cardiovascular strain, and neurocognitive deficits.

2. Central Sleep Apnea (CSA)

Central sleep apnea is less common in children. It occurs when the brain fails to send proper signals to the respiratory muscles, resulting in pauses in breathing without any physical airway obstruction.

• Causes: CSA in infants may be related to immature brainstem respiratory control. In older children, it can be associated with neurological disorders, infections, or trauma affecting the brain.
• Symptoms: Observed pauses in breathing without snoring, disrupted sleep, and potential underlying neurological signs.

1. During Sleep (Nighttime)

• Episodes where breathing temporarily stops repeatedly
• Mouth breathing due to difficulty breathing through the nose
• Loud snoring or sudden noisy breathing such as gasping or snorting
• Frequent tossing and turning or restless sleep throughout the night
• Difficulty staying asleep or not sleeping soundly, often waking up multiple times
• Excessive sweating during sleep
• Infants and young children may not always snore but can have disturbed or fragmented sleep
• Waking up abruptly due to choking, coughing, or struggling to breathe

2. During the Daytime (Awake)

• Morning headaches
• Mainly breathing through the mouth due to nasal obstruction
• Tendency to fall asleep easily in class or during short car or bus rides
• Decline in school performance, poor concentration, or memory problems
• Losing interest in learning or displaying inattentiveness
• Behavioral changes such as hyperactivity, impulsiveness, irritability, or aggression
• Poor weight gain or slow growth