Sleep apnea in a child: when to be alert and what to do
In a child suffering from sleep apnea (respiratory arrest), parents may notice symptoms such as restless sleep, intense snoring, choking in sleep, stuffy nose, behavioral problems, or growth disturbances.
Frequent snoring may be the first sign of obstructive sleep apnea. Often causes of childhood apnea are enlarged tonsils and/or adenoids, maxillofacial anomalies, laryngeal pathology. Less common causes are overweight, or congenital syndromes such as Down syndrome or Pierre Robin syndrome.
The effects of childhood apnea syndrome are divided into behavioral and physiological disorders
Behavioral disorders that may be seen in a child with apnea are:
restless sleep, hyperactivity, ADHD (attention deficit hyperactivity disorder), abnormal tardiness, and decreased interest in games and activities. In 2004, a study was conducted in Michigan that examined the behavioral characteristics of 254 boys. This study found that the risk of engaging in alcohol and drugs at a relatively young age was increased in children with sleep disorders.
Physical abnormalities that may be seen in a child with sleep apnea:
Increased growth hormone levels, abnormal bone development of the maxillofacial skeleton, such as formation of a long narrow face, convex profile, high and narrow palate (can be identified by a dentist), excessive body weight, headaches and recurrent upper respiratory infections, increased risk for metabolic disorders such as diabetes.
If you have reason to suspect that your child has sleep apnea syndrome, you should see an ENT doctor to determine the cause of the possible disorder and perform a study called a sleep lab to rule out or confirm the presence of sleep apnea and determine its severity. CPAP or special intra-oral devices, commonly used in adults, are unacceptable in pediatric practice because they can interfere with normal growth and cause undesirable changes in the facial skeleton.
In pediatric practice, treatments for apnea usually include surgery performed by an ENT doctor (e.g., surgery on the adenoids, in case of hypertrophy), lifestyle changes aimed at normalizing body weight, if necessary. Other possible treatments are performed by dentists, more often orthodontists, and include procedures such as palate correction, for example.
It is important for parents to remember, early detection and timely treatment of apnea in the child will avoid unnecessary risks in the future.