Obstructive Sleep Apnea in Children

Obstructive Sleep Apnea (OSA) is common in adults. Did you know that childhood sleep apnea is becoming a big problem world-wide? Between 1-4% of children world-wide have it.  Doctors are even diagnosing infants with sleep apnea. Black children are 3.5 times more likely than white children to develop OSA.

Why is obstructive sleep apnea such a big problem?

The main reason why more kids have OSA is that kids are getting fatter. An obese child is 4-5 times more likely to have breathing-related sleep problems than a non-obese child. So unfortunately, pediatricians are seeing the types of sleep problems that used to be seen only by adult doctors.

The other major cause of childhood sleep apnea is big tonsils and adenoids. It used to be the case that kids got their tonsils out for repeated bouts of throat infections. These days, most tonsillectomies in kids are done for obstructive sleep apnea.

The other cases of childhood sleep apnea happen because of genetic conditions such as Down Syndrome. These result in noses and throats that don’t work like they should. A fair number of kids with chronic nasal congestion from allergies get childhood sleep apnea as well.

So why is childhood sleep apnea a problem? Because if it isn’t treated somehow, it can lead to some serious consequences:

  • Failure to thrive in babies and small children
  • Developmental delay
  • Behavior problems
  • High blood pressure and heart disease

Childhood sleep apnea is different from adult OSA

It turns out that if you apply the adult standard definition of OSA to kids, you’ll miss a whole lot of cases.  That’s because children’s lungs are smaller and they breathe at faster rates. Unfortunately, there’s no good world-wide definition for children. Nevertheless, the risks of missing the diagnosis in kids are bad; It could not hurt to investigate if you suspect your baby or child may have it!obstructive sleep apnea 3

Sometimes, childhood sleep apnea is discovered during the course of an evaluation for ADHD, or even for bedwetting.  Many children thought to have attention deficits simply aren’t sleeping well! And children with disrupted sleep patterns tend to wet the bed more often.

Diagnosing obstructive sleep apnea

Diagnosis happens the same way as with adults, with the overnight sleep study. It’s important to make sure that the child really has the problem, and not merely “simple snoring”.  In children, it’s important to pay attention to inadequate breathing (hypopnea) in addition to obstructions. This is because hypopnea can lead to the same consequences as obstruction.



Because so much childhood sleep apnea is related to obesity, weight loss programs are effective, and can forestall the need for surgery. Healthy diet and regular exercise are good recommendations for anyone, but for children with sleep apnea, these habits can prevent early death from heart disease.

If weight loss is not an immediate option, removal of tonsils and/or adenoids is the treatment of choice.

Teen drivers with sleep apnea tend to be less alert and get into more accidents.  Until they receive therapy for OSA, it’s best that parents limit their driving.

Some kids with allergies have OSA due to constantly stuffy noses. Nasal sprays appear to help. Many varieties are available over-the-counter in the US.


Here the news is mixed: One study found that after tonsil removal, only about 1 in 4 children got better from their obstructive sleep apnea. However, a more recent study showed that many small children have a better quality of life after surgery.obstructive sleep apnea 2

The Bottom Line

The major take-home point is that obesity is a major cause of childhood sleep apnea. These kids live with these symptoms for many years before entering adulthood. It’s important to for them to lose weight while they’re still young!

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Rob Lindeman

Rob Lindeman is a sleep coach, entrepreneur, and writer living in Massachusetts. Ready to Get Rid of the Pacifier? Sign up for our FREE Video eCourse: The Paci-Free Method http://bit.ly/1U8Tdzx

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