Sleep apnea in young children

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Sleep apnea in young children

Question

My 19-month-old daughter constantly cries out in her sleep. Right before she does this, she appears to stop breathing. She also snores. Could she have sleep apnea?

Tammy
Iowa

Answer

Yes, she could have sleep apnea and should be evaluated by a doctor. Sleep apnea is a potentially serious disorder in which breathing repeatedly stops and starts during sleep.

Obstructive sleep apnea (OSA) is the most common type of sleep apnea in children. In OSA, the muscles in the walls of the throat (pharynx) relax while the child sleeps, so the walls collapse and obstruct the flow of air. After 10 to 30 seconds, the child rouses to a lighter level of sleep or brief wakefulness. The muscles tighten — relieving the obstruction — and the child breathes again.

In children, obstructive sleep apnea usually occurs between the ages of 3 years and 6 years. The most common cause at that age is enlarged tonsils and adenoids. A rare cause of obstructive sleep apnea in children is a tumor or growth in the airway. Certain conditions such as Down syndrome also can cause OSA.

Signs and symptoms of obstructive sleep apnea in children include:

  • Nightly snoring, often with intermittent pauses, snorts or gasps
  • Disturbed sleep
  • Irritability
  • Attention problems
  • Chronic fatigue

If you suspect that your child has obstructive sleep apnea, consult your child's doctor promptly. He or she may refer you to a specialist in the diagnosis and treatment of pediatric sleep disorders.

A doctor may diagnose obstructive sleep apnea by:

  • Sleep history
  • A sleep study (nocturnal polysomnography)

The most common treatment for children with obstructive sleep apnea is surgical removal of both the tonsils and the adenoids (adenotonsillectomy). After removal of the tonsils and adenoids, the child's upper airway is no longer blocked. Studies indicate that adenotonsillectomy has a high cure rate in children with obstructive sleep apnea.

If sleep apnea doesn't improve with removal of the tonsils and adenoids, treatment may include use of a continuous positive airway pressure (CPAP) machine, which delivers air through the nose at a pressure that keeps the upper airway passages open during sleep.

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