Related concepts:

Snoring, Obstructive sleep apnea, OSAS, Adenotonsillar hypertrophy

Introduction to sleep apnea:

Parents are quick to mention some things to their pediatrician: fevers, seizures, and bleeding. Snoring is another important symptom that your child’s doctor needs to know about, though it often goes unreported.

Any child who snores may have obstructive sleep apnea, and may not be getting adequate sleep.

Not all kids with sleep apnea snore. Even when they do, sleep apnea is often overlooked. Instead, the child may be diagnosed with a behavioral disorder -- most commonly ADHD.

What is sleep apnea?

Most people make some quiet snoring noises when they have (or are recovering from) a cold but this quickly resolves after the cold. Some people snore even when not ill, and some snore loud enough that others can easily hear them. In these cases, snoring may be the sign of obstructive sleep apnea syndrome (OSAS), where there is prolonged partial blocking, or intermittent blocking, of breathing during sleep. The obstruction is usually caused by large tonsils or adenoids, which may be temporarily enlarged by infection or allergies.

Children with sleep apnea do not get sound sleep. They may also get suboptimal oxygen to the brain at night. Obstructive sleep apnea can have a serious negative impact on a child's intellect and behavior.

OSAS can cause growth problems. It has also been linked to ADHD, poor school performance, learning difficulties, bedwetting, high blood pressures, lung disease, heart disease, and rarely even death.

OSAS is different from primary snoring (PS), the name given to snoring that doesn’t cause sleep disruption or breathing problems. Primary snoring is more common than OSAS.

Who gets sleep apnea?

OSAS occurs in about 2 percent of children. The peak age is 2 to 5 years old, but it can occur at any age.

In older children and adults, it is more common among the obese. It is also common in those with sickle cell disease, Down syndrome, birth injuries, or any other condition that might narrow the upper airway.

What are the symptoms of sleep apnea?

Classically, those with sleep apnea snore quite loudly for a bit, then are silent (sometimes not appearing to breathe), then snort briefly, move about, and resume snoring. If snoring is accompanied by nighttime breathing difficulty and pauses in breathing, then it may well be sleep apnea.

However, many children with OSAS do not follow this classic pattern.