Sleep Apnoea in Children

What Causes Childhood Sleep Apnoea?

Obstructive sleep apnoea (OSA) can affect children of any age as well as adults. In children, it is usually caused by enlarged tonsils or adenoids, which are both glands in the back of the throat. These glands can become enlarged due to inflammation, frequent infection or genetics. As in adults, children’s muscles relax during sleep which can mean the soft tissue in the upper airway partially or fully collapses, blocking the airway. If the airway is already partially blocked by enlarged glands, the airway is much more prone to obstructions during sleep.

OSA is much less common in children than in adults; somewhere between 1-5% of all children have the condition. Obesity, like in adults, greatly increases the likelihood of developing OSA; around 60% of obese children have obstructive sleep apnoea. Other causes of OSA in children may be a recessed jaw, or overbite, certain shapes in the soft palette in the roof of the mouth, a large tongue or weakness in the tongue and throat muscles due to conditions such as down syndrome or cerebral palsy. Using sedatives or opioids or being around people who smoke can also contribute towards childhood OSA.

Childhood central sleep apnoea (CSA) is extremely rare and is caused by issues with the breathing controls in the central nervous system, which is usually only associated with rare genetic disorders in children. CSA differs from OSA in that it is generally not associated with snoring and the pauses in breathing is caused by the lungs periodically stopping pumping.

What Are The Symptoms of Childhood OSA?

Snoring in conjunction with daytime symptoms such as excessive sleepiness, difficulty concentrating and behavioural problems such as hyperactivity are good indicators of likely sleep apnoea in children. Children with OSA will have pauses in their breathing while asleep and may choke or gasp, sweat more during sleep, often wake with headaches and are more prone to bedwetting.

The only way to accurately diagnose sleep apnoea in children is for them to undertake a paediatric sleep study. Home Sleep offers hospital grade paediatric sleep studies that involve one of our sleep scientists coming to your home to set your child up for the study so they can sleep in their own bed in a familiar environment.

What Are The Treatments For Childhood OSA?

In most cases of childhood OSA, the cause is enlarged tonsils or adenoids which can be removed by a simple surgical procedure called adenotonsillectomy.
Oropharyngeal exercises, also known as myofunctional therapy, increase the muscles tone in the upper airway and improve OSA and snoring in children and adults.
Mandibular advancement splints are mouthguards that hold the lower jaw forward during sleep, opening up the airway and reducing OSA and snoring.
In severe cases of childhood OSA, CPAP may be the best solution. A CPAP machine continuously pumps air into the airway through a sealed mask around the nose or nose and mouth in order to increase the air pressure in the upper airway, acting as a splint to hold the airway open.
Treating allergies or sinus inflammation reduce airway constriction, making it easier to breathe through the nose which can improve tongue posture caused by being forced to breathe through the mouth.
If a sleep study finds that a child’s sleep apnoea only occurs while lying on their back, positional therapy can be a good treatment option.
For obese children with OSA, weight loss can alleviate symptoms in the long term but will likely require other treatments that provide relief sooner.