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Obstructive Sleep Apnea

What Is Obstructive Sleep Apnea?

Sleep apnea happens when a person stops breathing during sleep. It usually happens because something is obstructing, or blocking, the upper airway. This is known as obstructive sleep apnea (OSA).

Obstructive sleep apnea can make oxygen levels in the body fall and interrupt sleep.

OSA is a common condition that can make kids miss out on healthy, restful sleep. If it's not treated, it can lead to learning, behavior, growth, and heart problems.

What Causes Obstructive Sleep Apnea?

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.

Other things that can make a child likely to have OSA include:

  • a family history of OSA
  • being overweight
  • medical conditions such as Down syndrome or cerebral palsy
  • problems of the mouth, jaw, or throat that narrow the airway
  • a large tongue, which can fall back and block the airway during sleep

What Are the Signs & Symptoms of Obstructive Sleep Apnea?

When breathing stops, oxygen levels in the body drop and levels of carbon dioxide rise. This usually triggers the brain to wake us up to breathe. Most of the time, this happens quickly and we go right back to sleep without knowing we woke up.

When this pattern repeats itself all night, people with obstructive sleep apnea don't reach a deeper, more restful level of sleep.

Signs of OSA in kids include:

  • snoring, often with pauses, snorts, or gasps
  • heavy breathing while sleeping
  • very restless sleep and sleeping in unusual positions
  • bedwetting (especially if a child previously stayed dry at night)
  • daytime sleepiness or behavior problems
  • sleepwalking or night terrors

Because OSA makes it hard to get a good night's sleep, kids might:

  • have a hard time waking up in the morning
  • be tired or fall asleep during the day
  • have attention or behavior problems

As a result, obstructive sleep apnea can hurt school performance. Teachers and others may think a child has ADHD or learning problems.

How Is Obstructive Sleep Apnea Diagnosed?

If your child snores regularly, is a restless sleeper, falls asleep 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) can help doctors diagnose sleep apnea and other sleep disorders. Sleep studies are painless and risk-free, but kids usually need to spend the night in a hospital or sleep center.

During a sleep study, doctors monitor:

  • eye movements
  • heart rate
  • breathing patterns
  • brain waves
  • blood oxygen level
  • snoring and other noises
  • body movements and sleep positions

How Is Obstructive Sleep Apnea Treated?

In mild cases of OSA, doctors may monitor a child for a while to see if symptoms improve before deciding on treatment.

When big tonsils cause sleep apnea, doctors will refer families to an ear, nose, and throat doctor (ENT). The ENT might recommend removing the tonsils (a tonsillectomy). Large adenoids may also be removed in an adenotonsillectomy. These surgeries often are effective treatments for OSA.

If something else causes OSA, a doctor may recommend continuous positive airway pressure (CPAP) therapy. In CPAP therapy, a person wears a mask during sleep. The mask may cover the nose only or the nose and mouth. It's connected to a machine that continuously pumps air to open the airways.

When excess weight causes OSA, it's important to work with a doctor on diet changes, exercise, and other safe weight-loss methods.

Reviewed by: Mary L. Gavin, MD
Date reviewed: March 2018