Although sleep apnea mostly affects the older population, it is also prevalent in children – usually under the age ten. Sleep apnea in children is just as troubling as in adults. If it remains undiagnosed and untreated, it leaves the children with learning difficulties, weak school performance, mood and behavior problems, poor interpersonal abilities, developmental delays, distortions in facial development and worse, high blood pressure and heart problems.
A common sleep disorder, sleep apnea occurs when the person stops breathing for brief periods that average 30 seconds. It is caused by an obstruction in the airway. In children, the majority of the cases of sleep apnea result from enlarged tonsils and adenoids. Some cases of enlargement are due to infection.
In many children, facial and structural deformities cause the narrowing of the airway. It can be, in rare cases, that the children are born with smaller jaw, larger tongue, and smaller opening of the throat.
A small minority of facial deformities are also caused by certain craniofacial syndromes such as Down Syndrome, Treacher Collins Syndrome, and Pierre Robin Sequence. Children with these syndromes have structural deformities in the jaw, nose, and mouth, and have poor muscle tone, making them more at risk for developing sleep apnea.
Tumors anywhere that affect the airway can also contribute to the development of sleep apnea, since the presence of a tumor diminishes the muscle tone and therefore causes an obstruction.
Becoming sadly more common, obesity can also a major factor in the development of sleep apnea in children. The fatty cells that amass in the throat tissue result in the narrowing of the airway.
As in adults, loud and heavy snoring is often the first symptom of sleep apnea in children – but often, the snoring can be very quiet and sound just like heavy breathing. But since more than 20% of children snore at some point, even without the presence of sleep apnea, it is important for the parents to look for other symptoms in their kids.
Other symptoms include mouth breathing, bedwetting, odd sleeping positions, extreme sweating while sleeping, hyperactivity, excessive sleepiness, short attention span, aggressiveness, and behavior problems. Other children may also do poorly in school, have learning problems, and not grow according to their age.
Unlike adults who have the tendency to get overweight, children with sleep apnea can sometimes be thin and may experience weight loss. This is because obstruction in the airway, especially in the throat and nose area, makes eating quite uncomfortable.
Since the enlargement of tonsils and adenoids is the common cause of sleep apnea in children, tonsillectomy and adenoidectomy, where enlarged tonsils and adenoids are removed, is commonly a successful treatment after other more conservative efforts to reduce their size has failed.
But those who don’t benefit from such surgeries or develop complications after going through them will often be prescribed “Continuous Positive Airway Pressure or CPAP. This is a nose mask connected to a machine that delivers pressurised air and keeps the airway open. Parents need to realise that CPAP may be a little uncomfortable to use, but some adjustments may allow the kids to get used to it.
The problem with CPAP is that it actually harms facial development in such a way that it will not only perpetuate the physical problems which cause sleep apnea (and various other jaw related problems), but it will worsen these problems. For this reason, it should only be a temporary measure for kids with severe sleep apnea, while better treatments are undertaken to correct their structural distortions.
This approach helps to develop the facial bones to their proper proportions which allows an increase in the dimension of the airway. Once the airway is enlarged, breathing becomes normal again, and sleep apnea diminishes or can even be eliminated.
Sleep apnea in children requires immediate medical attention. If parents suspect their kids have a sleep disorder, they need to promptly see a doctor, a sleep specialist or Sydney Sleep Dentistry. The severity of the case and identification of treatments will be based on the symptoms, medical evidence of enlargement of tonsils and adenoids, assessment of the airway and craniofacial development, and sleep test results.