Brief pauses in breathing during sleep are normal. But when breathing stops often or for longer periods, it's called sleep apnea. When someone has sleep apnea, oxygen levels in the body may fall and sleep can be disrupted.
It's more common in older people, but kids and teens can have sleep apnea too.
Sleep apnea happens when a person stops breathing during sleep. It is usually caused by something obstructing, or blocking, the upper airway. This is known as obstructive sleep apnea (OSA).
OSA is a common, serious condition that can make kids miss out on healthy, restful sleep. If it's not treated, OSA can lead to learning, behavior, growth, and heart problems. In very rare cases, it can even be life-threatening.
When we sleep, our muscles relax. This includes the muscles in the back of the throat that help keep the airway open. In obstructive sleep apnea, these muscles can relax too much and collapse the airway, making it hard to breathe.
This is especially true if someone has enlarged tonsils or adenoids (germ-fighting tissues at the back of the nasal cavity), which can block the airway during sleep. In fact, enlarged tonsils and adenoids are the most common cause of OSA in kids.
Risk factors for the development of OSA include:
Less commonly, sleep apnea can happen when someone doesn't get enough oxygen during sleep because the brain doesn't send signals to the muscles that control breathing. This is called central sleep apnea. Head injuries and other conditions that affect the brain increase the risk for this type of apnea, which mostly affects older adults.
When breathing stops, oxygen levels in the body drop. This usually triggers the brain to briefly wake us up so that the airway reopens. Most of the time, this happens quickly and we go right back to sleep without knowing we woke up.
Signs of OSA in kids include:
Because OSA makes it hard to get a good night's sleep, kids might:
As a result, sleep apnea can hurt school performance. Teachers and others may think a child has attention deficit hyperactivity disorder (ADHD) or learning problems.
If your child snores regularly, is a restless sleeper, is very sleepy during the day, or has other signs of sleep apnea, talk to your doctor. Your doctor might refer you to a sleep specialist or recommend a sleep study.
A sleep study (also called a polysomnogram) lets doctors check for OSA and record a variety of body functions while a child sleeps. Sleep studies also can help doctors diagnose central sleep apnea and other sleep disorders.
In a sleep study, sensors are placed at a few spots on the child's body with a mild adhesive or tape. The sensors are wired to a computer to provide information while the child sleeps. Sleep studies are painless and risk-free, but patients usually need to spend the night in a hospital or sleep center.
During a sleep study, doctors monitor:
If enlarged tonsils or adenoids are thought to be causing the apnea, the doctor will refer your child to an ear, nose, and throat doctor (ENT). The ENT might decide that an operation called an adenotonsillectomy is needed to remove the tonsils and adenoids. This often is an effective treatment for OSA.
If tonsils and adenoids are not the cause of OSA or if symptoms of OSA remain after adenotonsillectomy, a doctor may recommend continuous positive airway pressure (CPAP) therapy. In CPAP therapy, a person wears a mask that covers the nose and mouth during sleep. The mask is connected to a machine that continuously pumps air into it to open the airways.
When excess weight is a factor in OSA, it's important to work with a doctor on diet changes, exercise, and other safe weight-loss methods. In mild cases of OSA, doctors may monitor a child for a while to see if symptoms improve before deciding on treatment.