What is Obstructive Sleep Apnea?

• Sleep apnea is a condition where the breathing airways (as shown in the figure) close partially or completely during sleep.
• This leads to a poor sleep quality (also called as a fragmented sleep). Sleep apnea also leads to disturbances in the blood levels of oxygen and carbon dioxide (waste gas).

How common is sleep apnea in children?
International data suggests that around 1-5 out of a hundred would have sleep apnea!

What are the symptoms of sleep apnea in children?

• The primary symptom of sleep apnea is snoring during sleep. But all children with snoring do Not have sleep apnea.
• This snoring can be associated with intermittent gasps , short pauses, bed wetting and abnormal sleep postures (like sleeping with neck hyper extended)
• There can be associated day time symptoms like morning headaches, excessive day time sleepiness and some children might become hyperactive.

What are the conditions which predispose a child to have sleep apnea?

• The most common conditions which are associated with sleep apnea in children are adenoid enlargement and obesity.
• Others are children with neuromuscular disorders, craniofacial syndromes, Pierre robin syndrome, Down’s syndrome etc. These are detailed in the relevant sections.

What are the complications of Sleep Apnea in children?

• Complications of sleep apnea are secondary to the poor sleep the child is getting and changes in the oxygen and carbon dioxide levels which occurs in the body.
• Neuro-cognitive complications are seen as such as hyperactivity, poor attention span, sleepy in day (except than a small day time nap), poor school performance, poor concentration.
• Metabolic complications such as increased weight, alterations in blood sugar and lipid levels.
• Cardiac complications are seen such as Pulmonary hypertension and congestive heart failure.

How do you diagnose sleep apnea in children?

• Well the question is that which child with snoring has sleep apnea. It is a difficult question to answer since No signs and symptoms would give us a good clue.
• Hence, children who have a adenoid hypertrophy or obesity or other complex conditions AND are snoring should be evaluated for sleep apnea.
• Sleep study in children is the GOLD STANDARD for diagnosis of sleep apnea. For more on sleep study in children.