If left untreated, sleep apnea can have significant consequences on a child’s growth, well-being, and behavior.
Chronic snoring is a sign of an abnormal flow of air through the upper airways that extends from the nose and mouth to the lungs. It is turbulence in these passages that produces the snoring sound.
Snoring often occurs hand-in-hand with sleep apnea, and, if your child snores, it is important to have it checked out. Other causes of snoring include allergies and enlarged tonsils or adenoids, both of which can be treated.
Chronic snoring in a child is a red flag that the child needs to be evaluated either by a sleep specialist or a pediatric otolaryngologist (an ear, nose, and throat specialist).
If left untreated, mouth breathing can spur the development of sleep apnea. By breathing through the mouth, the muscles of the jaw are in a relaxed position, leading an elongation of the face over time. It can also contribute to the weakness of the tongue and other muscles of the mouth and throat.
As a result, snoring and sleep apnea may more likely to occur in mouth-breathers than people who breathe normally.
Sleep apnea frequently occurs when the soft tissues at the back of the throat block the airway. Tightening the jaw and tongue can help prevent the collapse of the airway while in a supine (upward-facing) position but can also lead to teeth clenching and grinding.
Although mouthguards can prevent damage to the teeth, treating sleep apnea can usually resolve these and other symptoms of the disorder.
Sleep apnea is associated with decreased oxygen levels, spikes in blood pressure and heart rate, and increases in the stress hormone cortisol. When this occurs during sleep, excessive sweating is a common consequences.
When breathing becomes difficult, as it does with sleep apnea, it can manifest with excessive movements during sleep. This is often the first sign of sleep apnea is younger children whose teeth have not yet fully developed.
If the covers are twisted into a ball at the base of the bed or found on the floor in the morning, this could be a sign of sleep apnea or other forms of respiratory impairment. Chronic restless sleep in children indicates the need for an evaluation by a sleep specialist.
Infants often take two to three daytime naps lasting 30 minutes to two hours. Between six and 12 months of age, a child will usually take two naps daily, lasting anywhere from 20 minutes to a few hours.
By school age, it is very unusual for a child to require daytime naps unless they are sleep deprived. Sleep apnea is one such cause that should be explored by a sleep specialist.
Although sleep enuresis may be due to infection, stress, or other medical conditions, bedwetting can also be a sign of sleep apnea. Sleep apnea is believed to cause chemical imbalances in the brain that caninduce bedwetting not only in children but adults as well.
Sleepwalking is associated with confusional arousal in which a child appears to awaken but remains in a confused, subconscious state. These episodes most often occur in the first third of the night.
Although the causes of sleepwalking are often unidentified, sleep apnea is believed to be a contributing factor. Brief stirrings are common when a child resumes breathing after a gap, triggering confusional arousal.
According to a 2018 review of studies in Frontiers of Psychology, children and adults with sleep apnea are far more likely to be sleepwalkers than those without.
Children with sleep apnea will often “fall off the growth curve,” meaning that they are abnormally small for their age. The interruption of slow-wave sleep is believed to be the cause of this.
The treatment of sleep apnea has been shown to reverse the trend in some children and restore the growth trajectory.
Unlike adults who are sleep deprived, who usually experience daytime fatigue, children who are sleep deprived will often have the opposite effect, demonstrating hyperactive behaviors as well as forgetfulness, aggressiveness, distractability, and poor impulse control.
Sleep apnea is a condition often overlooked in children with ADHD, leading to misdiagnoses and inappropriate treatments.
Be sure to keep a record of your child’s symptoms, including dates and a description of events. If indicated, the sleep specialist can organize a non-invasive overnight sleep study (polysomnogram).
