Child’s Snoring Could Be Sleep Apnea

September 26, 2012

Stephanie Cheetham, Erin Stubbs, MD,

A child’s snoring may not be as innocent as it seems. Snoring could be a sign of obstructive sleep apnea, which is present in an average of 3 percent of children.

The main symptom of OSA is nighttime snoring. Other nighttime symptoms include pauses in breathing while sleeping, sweating, restless sleep, sleeping in unusual positions and bed-wetting. Daytime symptoms include hypo-nasal speech or mouth-breathing. Children might also complain of early morning headaches. Young children may fall asleep during short car rides, require extra naps or be easily distracted. Older children may fall asleep in class or have learning disabilities. The condition can also cause attention deficit disorder, with or without hyperactivity.

OSA occurs when small or narrow upper airways partially or completely obstruct breathing during sleep, restricting the exchange of oxygen and carbon dioxide. Two associated risk factors for OSA are obesity and enlarged tonsils. Other children with increased risk for developing OSA include those with cerebral palsy, Down syndrome, muscular dystrophy or abnormal facial shapes, including small chins, midline facial defects or recessed chins.

It is important to diagnose OSA to prevent complications such as poor growth, mental retardation, high blood pressure and lung disease. Secondary to excessive daytime sleepiness, children may also have poor school performance, be easily distracted and have behavioral problems.

To diagnose sleep apnea, a sleep study known as polysomnography is performed. Children who snore most nights of the week should be tested. The sleep study is usually performed overnight at a sleep laboratory and is evaluated by a specially trained doctor.

The first line of treatment for diagnosed OSA is removal of the tonsils and adenoids. If surgery is too risky, a machine that provides positive airway pressure while the child is sleeping can be used. Other treatments include weight loss if the child is obese or corrective facial surgery if there are structural abnormalities. Nasal steroids or special positioning also can help.

If your child snores on a regular basis, he or she should be evaluated to prevent long-term consequences. If you have any questions or concerns, speak with your pediatrician.

Dr. Stephanie Cheetham is a pediatric resident at Carolinas Medical Center, and Dr. Erin Stubbs is a board-certified pediatrician at CMC Myers Park Pediatrics.