Signs of Pediatric Obstructive Sleep Apnea

What is Sleep Apnea?

Obstructive sleep apnea (OSA) is when your child’s breathing repeatedly stops and starts during sleep due to an obstruction in the upper airway. You may hear snoring with pauses and gasps that disrupt and wake your child in the middle of the night. You may also hear loud snoring and breathing if they fall asleep in the car seat!

The tonsil tissue in the back of the throat and enlarged adenoid tissue behind the nose are two of the most common sites of obstruction in children.

What are the common symptoms?

Common symptoms of sleep apnea include:

• Snoring
• Pausing, gasping, choking
• Mouth breathing
• Restless Sleep
• Overnight awakenings
• Daytime fatigue
• Behavior issues
• Hyperactivity
• Bedwetting
• Large tonsils when looking in the throat
• Large adenoid tissue (this can not be visualized by looking in the throat, but can be examined with a scope through the nose)
• The adenoid tissue tends to mimic the size of the tonsil tissue in young children, so large tonsils usually mean large adenoid tissue

Why is sleep apnea concerning?

Sleep apnea causes repeated disruptions in your child’s sleep cycles. The body awakens itself into lighter sleep to open the airway and resume normal breathing. As such, deeper sleep may become fragmented and growth hormone secretion may be compromised. When your child’s sleep is disrupted they do not finish complete sleep cycles and can miss out on the important parts of sleep that allow for growth hormone release. Fragmented sleep can also make it hard for children to stay focused and learn as there are important parts of the sleep cycles that allow us to store memories and remove waste from the previous day. Fortunately, children whose sleep apnea is treated undergo a rebound growth spurt!

Sleep disruptions can also cause mood and behavior changes which are some of the most common manifestations in children. You may see hyperactivity, inability to hold still, or aggressive behavior. Every child is different!

Think of the last time you had a bad night of sleep and how you felt the next day. Now imagine this day after day and how you would function. Poor sleep quality can also affect the hormones that affect our appetite and that tell our body when we are full after eating which is why poor sleep has been linked to obesity. On the opposite end, sleep apnea can lead to poor growth in children because of the lack of growth hormone released due to repeated disruptions

What should I do?

If you are concerned about your Wee One’s sleep talk with your primary care provider about their sleep symptoms and undergo a thorough exam. If your child’s symptoms and exam are concerning enough, your primary care provider may refer to an ENT provider like me for more evaluation!

An ENT or your primary care provider may also discuss the option of a sleep study where your child stays overnight in a lab with you to determine if they truly have OSA and to what extent. This is helpful in making surgical decisions such as tonsillectomy or adenoidectomy, although not every child undergoes a sleep study prior to surgery. When treatment is indicated it can help your child sleep well, feed well, and feel well!

Need more help with sleep? I offer 1:1 sleep coaching plans with support and have downloadable guides to help your child with sleep!