Sleep Apnea in Children: Recognizing the Signs and Symptoms

Home » Sleep Apnea in Children: Recognizing the Signs and Symptoms

February 4, 2025
9:43 am

Pediatric sleep apnea is a sleep problem in children. Their breathing stops and starts during sleep due to blocked airways or brain signal issues.

Children show different signs than adults, and their symptoms are not always clear. However, sleep apnea can affect their growth, learning, and behavior.

It is essential to find it early. If untreated, it can cause heart problems, trouble learning, and a poor life.

Parents and teachers should watch for signs. Children may not know they have it.

A 2020 study in JAMA Otolaryngology-Head & Neck Surgery found that delays in diagnosis can cause long-term problems. This shows why early care is needed.(JAMA Otolaryngology–Head & Neck Surgery)

This article explores the symptoms, causes, diagnosis, and treatment options for sleep apnea in children.

Understanding Pediatric Sleep Apnea

Pediatric sleep apnea is different from adult sleep apnea. The causes and symptoms are not the same.

Adults often feel very sleepy during the day. However, children may act hyperactive or get easily irritated.

There are three main types of sleep apnea: obstructive sleep apnea (OSA), central sleep apnea (CSA), and mixed sleep apnea.

OSA is the most common type. It occurs when the airway becomes blocked, which can be due to large tonsils or obesity.

CSA is rare in children. It happens when the brain does not send the right signals to the breathing muscles.

Mixed sleep apnea is a combination of both OSA and CSA.

Children have smaller airways than adults, and their bodies grow quickly, making them more likely to have airway problems.

The American Academy of Pediatrics says that OSA affects 1–5% of children and is most common in children aged 2 to 8. (American Academy of Pediatrics)

Nighttime Signs and Symptoms

Persistent Loud Snoring

Frequent, loud snoring is a hallmark of pediatric sleep apnea. Unlike occasional snoring, it often signals airway obstruction. A 2019 study in Pediatrics found that 60% of children with habitual snoring had OSA confirmed via polysomnography. Snoring may worsen during colds or allergies but warrants evaluation if it is chronic. Caregivers should note snoring volume and consistency, as subtle changes can indicate severity.

Observed Pauses in Breathing

Witnessed apnea—sudden silence during snoring followed by gasping—is a critical red flag. These pauses, lasting 10+ seconds, occur when the airway collapses. A 2021 review in Chest Journal emphasizes that caregivers often overlook brief pauses, mistaking them for deep sleep. Video recordings during sleep can aid clinicians in diagnosis.

Daytime Symptoms and Behavioral Indicators

Excessive Daytime Sleepiness

While toddlers may resist naps, older children with sleep apnea often struggle to stay awake during school or play. A 2018 study in Sleep Medicine linked fragmented sleep in children with OSA to impaired daytime alertness, mimicking ADHD symptoms. Teachers may report frequent drowsiness or “zoning out” in class. (Sleep Medicine)

Behavioral Issues

Hyperactivity, aggression, or mood swings are paradoxical signs of sleep deprivation in children. Research in the Journal of Developmental & Behavioral Pediatrics shows that 25–50% of children with OSA exhibit ADHD-like behaviors, often misdiagnosed before sleep studies. (JDBP)

Age-Specific Variations

Infants/Toddlers

In infants, apnea may manifest as prolonged breath-holding or cyanosis (bluish skin). Poor feeding and failure to thrive are key indicators. The Journal of Perinatology associates untreated infant OSA with developmental delays due to oxygen deprivation. (Journal of Perinatology)

Adolescents

Teens may report daytime fatigue resembling adult OSA. Obesity is a growing risk factor; a 2022 CDC report notes that 35% of adolescents with obesity have undiagnosed sleep apnea.

Differential Diagnosis

ADHD and Sleep Apnea

ADHD and sleep apnea have similar symptoms. These include hyperactivity and trouble focusing.

A 2021 study in the Journal of Clinical Sleep Medicine found that 30% of children with ADHD also had sleep apnea.

Misdiagnosis can delay proper treatment. This is why sleep studies are essential for children with behavior problems. (Journal of Clinical Sleep Medicine)

Allergies and Asthma

Allergic rhinitis and asthma can look like sleep apnea. They cause coughing, congestion, and restless sleep at night.

A 2018 report in Pediatric Pulmonology says children with uncontrolled asthma are at a higher risk of sleep apnea, which occurs because of airway swelling.

Treating allergies and asthma can help tell them apart from sleep apnea. (Pediatric Pulmonology)

When to Seek Medical Evaluation

Red Flags for Parents

Parents should watch for warning signs in their child’s sleep. Seek medical help if a child snores, often stops breathing during sleep, or has behavior problems in the daytime.

A 2022 American Academy of Sleep Medicine guideline advises a sleep study for children who might have sleep apnea. This is very important for kids with risk factors like obesity or face structure problems.

Getting help early can stop serious health problems in the future. (American Academy of Sleep Medicine).

Risk Factors to Monitor

A child’s risk of sleep apnea is higher if family members have it. Obesity also increases the chance of having sleep apnea. Some genetic conditions, like Down syndrome, make it more likely.

The Journal of Pediatrics says 60% of children with Down syndrome have sleep apnea. This shows why regular checkups are essential for children at high risk.

Conclusion

Knowing the signs of pediatric sleep apnea is very important. Early diagnosis and treatment can help. Symptoms include loud snoring, pauses in breathing, and daytime tiredness. Some children may also have trouble focusing or acting out. Signs can change based on age and severity.

Parents should watch for these signs, especially if a child is overweight or has big tonsils. These can increase the risk of sleep apnea. Getting help early can improve sleep, school performance, and overall health.

Experts say parents and doctors need to know more about this issue. Many children go undiagnosed, which can cause long-term problems. Raising awareness can help children get the care they need.

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