Sleep Apnea in Children

Parenting today is much more difficult than it was a generation ago. In addition to the crippling rule about not hitting our kids, we have to contend with more advice, purchase more gear and the worst, worry about more medical diagnoses. While our parents barely knew what autism, food allergies and obesity were, we are literally losing sleep about apnea and whether our kids have it. If you have this concern (it is one which crosses my mind every time my monsters wake up on the wrong side of the crib), I hope this helps.

1. What is sleep apnea?  A period of time where breathing stops or is markedly reduced.  Most commonly, it is caused by some kind of obstruction or blockage that gets in the way of breathing.  The airway can be blocked at any point along its path from your nose and mouth to your throat.  Sometimes the tongue and the muscles relax too much during sleep.   Obesity and alcohol use increase the risk of having sleep apnea in adults.  Sometimes the obstruction is from the tonsils and/or adenoids, which is usually the case with children.

2. How common is it in children? According to the American Sleep Apnea Association, 1-4% of children suffer from sleep apnea, most of them between the ages of 2 and 8.

3. What are the signs?
In children under 5, look for:
– snoring
– mouth breathing
– sweating
– restlessness
– frequent wakening

In children over 5, look for the above as well as:
– bed wetting
– doing poorly in school
– stunted growth for their age
– inability to focus

4. What are the consequences? In addition to the irritability of a child who isn’t sleeping well and the above symptoms, kids with sleep apnea may be misdiagnosed with Attention Deficit Disorder. There is a convincing link between sleep apnea and childhood obesity. Left untreated, sleep apnea can lead to depression, high blood pressure, heart problems and developmental delay.

5. When should you talk to your doctor? Considering the severity of the consequences, if you have any suspicion, or if you child is exhibiting any of the above symptoms, it is worth having the conversation with your Pediatrician or Family Physician. I recommend scheduling a separate visit, so there is time for a thorough evaluation. If further testing is required, your doctor will order a polysomnography either at home or in a facility. It is a painless test that monitors different aspects of sleep behaviors including brain waves, eye movement, blood oxygen level and muscle tension.

In many cases, a child with sleep apnea can be cured by removal of the tonsils and adenoids. If this does not work or if enlarged tonsils and adenoids are not the underlying problem, a machine called a C-PAP may be prescribed. It is worn on the face and distributes positive pressure to keep the airway open.

If you have a grouchy kid in the morning, don’t jump right to a sleep apnea conclusion. Do, however, keep it in mind.  In addition to sleep apnea, children can experience many other sleep disorders, and your doctor can help you sort it out. It’s important to remember how important good sleep habits are. This is a great reminder for me as my kids right now are in total summer, no bedtime, wheels off the wagon mode. I’m giving them until August 1st and then I’m going become a responsible 2012, chronically worried parent … until then, it’s Cheerios for dinner, self-applied sunscreen and exhaustion. I love the summer!

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