Sleep Apnea in Children

Snoring is extremely common in adults. In fact, about half of people snore at some point in their lives. Snoring is more common in men, though many women snore – about 40 percent of adult men and 24 percent of adult women are habitual snorers. However, when it comes to children, snoring is not common and should be seen as a cause for concern, not as a funny little quirk. Keep reading to learn about sleep apnea in children, the dangers, how it is diagnosed, and how it is treated.

Sleep Apnea in Children: Is It Normal for Kids to Snore?

Approximately 10% of children snore regularly, 25-40% of children have sleep-disordered breathing and about 2-4% of children experience obstructive sleep apnea – which is when a person stops breathing for 10 or more seconds during sleep. Children 3 years of age and older tend to let out some snores during deep sleep stages, however, loud and regular snoring is not common and should be reported to your pediatrician.

This is especially true if your child’s snoring interrupts their sleep. Occasional light snoring that does not happen more than 2 times a week is normal, however, it should not be interrupting their sleep. Sleep apnea in children can seriously affect the child’s quality of life in a number of ways, including:

• Impaired brain development
• Reduced academic performance
• Cardiovascular issues like high blood pressure
• Altered metabolism
• Behavior problems

How Do I Know if My Child has Sleep Apnea?

If you’re worried whether or not your child’s snoring is normal or a sign of sleep apnea in children, take note of the following symptoms:

• Snoring, often with pauses, snorts, or gasps
• Heavy breathing while sleeping
• Very restless sleep and sleeping in unusual positions
• Bedwetting (especially if a child had stayed dry at night)
• Daytime sleepiness or behavior problems
• Sleepwalking or night terrors

In addition to these symptoms, it is important to talk to your child’s pediatrician if they exhibit the following behaviors:

• Hard to wake up. Is your child difficult to get out of bed in the morning? It might not just be because they don’t want to get ready and go to school. It can be a sign of a more serious issue since sleep apnea in children greatly affects their quality of sleep.
• Tired all day. Everyone has moments during the day when they feel tired, however, if it is excessive for your child and seems to be happening regularly, make sure you mention this to your doctor.
• Hyperactivity. While it sounds counterintuitive, a hyperactive child who has trouble paying attention could be suffering from sleep apnea. It is often confused for a learning disability or a form of ADHD since it can so greatly affect a child’s performance at school.

Where Sleep Apnea in Children Can Begin

Snoring is simply caused by air that cannot flow freely through the airway at the back of the throat — as a person inhales or exhales, tissue around the airway vibrates, which causes the noise of snoring. This can happen to anyone, however, there are certain factors that could make a child more likely to snore. These include underlying risk factors, breastfeeding, pacifiers, and bottle feeding.

Risk Factors

Risk factors that can make it more likely for a child to snore or develop sleep apnea in children include:

• Obesity. Children who are overweight are more likely to snore than children who are not overweight. Weight gain can make airways smaller and, usually, losing weight can help with snoring.
• Asthma. Children who have asthma already have breathing that can be inhibited, and this can lead to snoring.
• Allergies, congestion, and flu-like symptoms. Congestion can easily cause blockage in an otherwise open airway, which can lead to snoring. Sometimes, dealing with a child’s allergy or sinus issues can help reduce snoring.
• Tonsils. The most common cause of sleep apnea in children is large or swollen tonsils.

Breastfeeding

It is important to know that no matter how you feed your child, whether it is by breastfeeding or bottle feeding, a fed baby is best. There is an unfortunate stigma surrounding bottle-feeding, and while there is nothing wrong with bottle-feeding, there are statistics that prove its relation to sleep apnea which is what this blog will be referring to.

Breastfeeding strengthens the facial muscles and grows the maxillary complex forward, expanding the palate. Any breastfeeding for longer than 1 month was associated with a lower risk of witnessed sleep apnea.

Pacifiers and Bottle Feeding

There are many benefits to using pacifiers as a young baby. One way that pacifiers are beneficial is that they are a way to comfort infants before they are able to self-soothe. Babies aren’t able to self-soothe until around 3 months old and, until then, pacifiers can help calm and comfort infants. In addition, pacifiers also help to reduce the chances of SIDS. Sudden Infant Death Syndrome happens in deep sleep stages, and infants who use pacifiers don’t fall asleep as deeply.

However, as helpful as they are, pacifiers also come with their own set of risks. These include:

• Pacifiers can harm the growth and development of the mouth and teeth
• Prolonged use can cause changes in the shape of the roof of the mouth
• Prolonged use can also prevent proper growth of the mouth and create problems with tooth alignment

This harm to the inside of the mouth can also be attributed to sleep apnea in children. When considering using a pacifier, it is ideal to wean your baby as soon as he or she is able to begin self-soothing at around 3 or 4 months old, but preferably within the first year.

The Dangers of Children and Sleep Apnea

Sleep apnea in children can cause many dangerous long-term side effects, just as it can do with adults. Since untreated sleep apnea causes constantly disturbed sleep, it can affect many areas of a child’s life. These include:

• Poor academic performance. When a child is perpetually tired from a poor night’s sleep, it can cause difficulty paying attention in class and difficulty in processing information. This leads to learning difficulties and poor academic performance.
• Misdiagnosis of ADHD. Poor sleep can cause hyperactivity in children. As such, it is estimated that symptoms of obstructive sleep apnea may be present in up to 25 percent of children with a diagnosis of ADHD. https://www.healthline.com/health/sleep-apnea-in-children#effects
• Social difficulties. Due to hyperactivity and poor academic performance, children suffering from sleep apnea may have a harder time in social situations.
• Physical dangers. In severe cases of sleep apnea in children, it can cause high blood pressure (increasing the risk of stroke and heart attack), childhood obesity, growth and cognitive delays, and heart problems.

How Sleep Apnea is Diagnosed

If you have noticed signs of sleep apnea in your child and would like to see if your child indeed has it, it is first recommended to talk to your pediatrician. Your doctor might refer you to a sleep specialist to perform a sleep study to help diagnose your child. You may also have the option to do a home sleep test, which measures the heart rate, blood oxygen level, airflow, and breathing patterns.

During a sleep study for sleep apnea in children, doctors check:

• Eye movements
• Heart rate
• Breathing patterns
• Brain waves
• Blood oxygen levels
• Carbon dioxide levels
• Snoring and other noises
• Body movements and sleep positions

Once the test is complete and all assessments have been made, the doctor will make the diagnosis and help with the next steps in treatment.

How It is Treated

Since there is no single way sleep apnea occurs in each and every person who suffers from it, your doctor may recommend a few different ways to treat your child. These can include:

• Weight loss. If your child has above average weight, your doctor may recommend weight loss and healthier habits. This usually helps to solve the issue with children who have above average weight, and it is important to work closely with your doctor while helping your child with any weight loss regimen.
• Sleep habits. It is important to take a look at your child’s sleep habits to see if that may help solve the issue as well. This can include setting a scheduled bedtime and not staying up too late, limiting and cutting off screentime a couple of hours before bed, not eating sugary foods before bed, and having a comfortable and dark place to fall asleep.
• Breathing devices. Your doctor may recommend a mouthpiece or CPAP machine to help your child’s breathing at night. While PAP devices are common for treating OSA in adults, in children they are usually reserved for OSA that persists after surgery to remove the tonsils and adenoids.
• Surgery. One of the main treatments for sleep apnea in children is to remove the tonsils, also known as an adenotonsillectomy. By eliminating the tissue that most frequently blocks the airway, this surgery can reduce snoring and pauses in breathing at night.
• Dental appliance. Many dentists, such as Dr. Gorman at Gorman Health and Wellness Center, can offer the solution of a dental appliance. With this dental appliance device (DNA), your doctor can gradually expand the upper and lower jaws, opening up the airway and allowing for easier breathing and less snoring for your child.

About Gorman Health and Wellness Center

Our clinic specializes in permanent treatments for sleep apnea. After the patient has received a sleep apnea diagnosis, Dr. Martin Gorman will talk with them about their symptoms, review their medical history, and may perform a 3D scan utilizing state-of-the-art dental technology to evaluate possible obstructions. Once he is familiar with the details of their condition, Dr. Gorman will create a personalized treatment plan with the goal of improving their nighttime breathing.

If you are ready to make a permanent change to your sleep apnea and feel better with more energy, we’re here to help you. With 44 years of experience, we are committed to providing you with the kind of service we would want for ourselves and our families.

Find out more about Dr. Gorman and the Gorman Health and Wellness Center by visiting www.mgormandental.com