Childhood Sleep Apnea

When your child snores, it may seem cute, but snoring may also be a serious sign of childhood sleep apnea. 

While snoring can happen for a variety of reasons, such as sinus congestion due to a cold, allergies or other illness, if you’re noticing snoring in your child several nights a week, it may be a sign of obstructive sleep apnea, a serious sleep disorder. 

Obstructive sleep apnea (OSA) occurs when the soft tissue and muscles in the head and neck that help keep the upper airway open fall into the throat when your child is relaxed during sleep, causing airway obstruction and interruptions in breathing. 

These interruptions can happen a dozen to hundreds of times a night depending on how severe your child’s sleep apnea is, and these interruptions can last a few seconds to a full minute. 

Pediatric Sleep Apnea

Research studies conducted by the National Sleep Foundation estimate that 1.2 to 5.7 percent of children have obstructive sleep apnea, many undiagnosed. In many instances, sleep apnea is overlooked or misdiagnosed in children because its symptoms often mimic other health conditions. 

According to the American Sleep Apnea Association, sleep apnea symptoms in children often develop between the ages of 2 and 8 years old. Children with severe sleep apnea often develop symptoms between 3 and 5 years old, but the condition can also impact infants and older children. 

While some children outgrow their obstructive sleep apnea, the majority do not and suffer from lifelong side effects caused by the condition. 

The Signs of Pediatric Sleep Apnea

Other signs of obstructive sleep apnea in children include: 

  • Frequent snoring, snorts, choking or gasping for breath
  • Heavy breathing while sleeping (hypopnea)
  • Very restless sleep, tossing and turning, difficulty staying asleep, unusual sleep patterns
  • Sleeping in unusual positions, such as with the head arched far back
  • Bedwetting beyond potty-training years 
  • Daytime sleepiness 
  • Sleepwalking
  • Night terrors or nightmares
  • Difficulty staying awake during the day and daytime sleepiness due to poor sleep
  • Irritability
  • Learning difficulty, inability to focus
  • Morning headaches
  • Mouth breathing
  • Smaller than peers, labeled as failure to thrive

In addition to these symptoms, sleep apnea can increase the risk of developing severe medical conditions such as high blood pressure, obesity, being overweight, diabetes and cardiovascular problems. 

Oral Resting Posture

Proper oral posture is the term to describe a situation in which the tongue is at rest on the roof of the mouth, with the teeth touching or slightly apart. Lips are closed without straining and the child is breathing through their nose. When this situation exists, your child’s maximum airway potential and jaw growth potential are achieved, which means a significant reduction in the chance of developing sleep apnea. If your child does not have proper oral resting posture it could be a risk factor for the sleep-breathing disorder. 

Child Sleep Apnea and Behavioral Disorders

Sleep apnea and other sleep breathing disorders have also been linked to conditions such as ADD/ADHD, irritability and outbursts in children. Some research has shown that children with sleep apnea or those who experienced interrupted sleep from snoring had a 40 to 100 percent greater risk of developing ADHD-like symptoms than children who breathe well at night. 

But why? Primarily because your child is tired! Despite getting a “full night’s sleep,” if your child experiences frequent sleep interruptions due to sleep apnea or sleep-disordered breathing, they’re not getting restful sleep. Also, consistently lower oxygen levels are unhealthy and negatively impact the brain and can affect behavior. 

Lack of sleep has a significant impact on the development of children and impacts them differently than adults. Instead of feeling sluggish and tired like sleep-deprived adults, children are more likely to exhibit behavioral problems such as mood swings, being excitable, and difficulty sitting still, focusing and getting along with others. Unfortunately, some parents are not aware that their child’s symptoms are related to a sleep disorder. 

The Causes of Child Sleep Apnea

Child sleep apnea can be caused by a range of issues, including airway problems such as a narrow airway, muscle weakness in the throat and mouth, and enlarged tonsils or adenoids. 

Other contributors to sleep apnea in children include:

  • Poor coordination of airway movements
  • Chronic upper airway infections and sinus congestion
  • Obesity
  • Deviated septum or narrow nasal passages
  • Enlarged nasal turbinates
  • Tumors
  • Craniofacial abnormalities
  • Genetic disorders, such as Down syndrome and cerebral palsy
  • Neuromuscular disorders

An underdeveloped midface caused by facial growth issues can also contribute to the development of sleep apnea. This situation occurs when the upper jaw does not fully develop due to environmental influence or poor oral habits such as extended thumb sucking or pacifier use. When the midface does not fully develop, the upper airway does not fully develop and can lead to airway obstruction and breathing interruptions. 

Another cause of airway obstruction and sleep apnea is interruption in lower jaw development. When the lower jaw is set too far back, the tongue is also set far back, which means it can fall and block the airway during sleep. 

Treatment for Child Sleep Apnea

If you suspect that your child has sleep apnea, the first step is to contact Miami Designer Smiles to discuss the need for a sleep study. During the sleep study, your child’s breathing will be monitored to count interruptions, how often they wake, and how many hypopnea episodes they have. After the sleep study, if it is determined that your child has sleep apnea, we will determine the best treatment course. 

Treatment options for child sleep apnea include:

Avoiding allergens

If your child has allergies contributing to chronic congestion, we recommend that you work to prevent airway irritants and allergens, including tobacco smoke. 

Weight loss

Being overweight or obese can contribute to the development of sleep apnea or make existing sleep apnea worse. If this is the case, you may want to seek nutrition information from your child’s pediatrician. 

Removal of the tonsils and adenoids

If the cause of your child’s airway obstruction is enlarged tonsils and adenoids, having them removed surgically can improve the flow of air through the airway. 

Medications

Some children see improvements in their sleep apnea with the use of topical nasal steroids. Allergy medications may also benefit those with sleep breathing issues because of sinus congestion. 

Positive airway pressure therapy

With continuous positive airway pressure (CPAP) treatment, air is sent through a mask worn over your child’s nose or nose and mouth. This air helps to keep the airway open. Doctors often treat pediatric OSA with positive airway pressure therapy either through a CPAP or BiPAP machine. This treatment may be prescribed for children with severe sleep apnea.  

Oral appliances

Oral appliances therapy, also known as mandibular advancement devices, may be right for your child if permanent teeth have erupted. These appliances can help prevent airway obstruction and interruptions in your child’s breathing by moving the lower jaw and tongue forward. Oral appliance therapy is used by our Miami Designer Smiles team and increasing in popularity for children with mild to moderate sleep apnea.

Jaw Development Orthodontics

Jaw development orthodontics can help improve sleep apnea by helping the jaws to achieve their full genetic potential. When the jaws reach their genetically-intended size, the airway is widened and breathing improves. 

Want to learn more about how oral appliance therapy can help treat child sleep apnea? Miami Designer Smiles partners with a sleep-specialized physician who can help diagnose potential airway issues during sleep. We also offer a low-radiation CBCT scan to evaluate the airway and work with ENT specialists for evaluation and appropriate treatment to maximize the airway. 

Learn more by calling us now. 

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