Obstructive Sleep Apnea

What Is Obstructive Sleep Apnea?

Sleep apnea is when a person stops breathing during sleep. It usually happens because something obstructs, or blocks, the upper airway. This is called obstructive sleep apnea (AP-nee-uh).

Obstructive sleep apnea (OSA) interrupts sleep and can make the body's oxygen levels fall or carbon dioxide levels rise. This can make kids miss out on healthy, restful sleep. Untreated obstructive sleep apnea can lead to learning, behavior, growth, and heart problems.

What Causes Obstructive Sleep Apnea?

When we sleep, our muscles relax. This includes the muscles in the back of the throat that help keep the airway open. In obstructive sleep apnea, these muscles can relax too much and block the airway, making it hard to breathe.

This is especially true if someone has large tonsils or adenoids, which can block the airway during sleep.

Other things that can make a child likely to have OSA include:

• a family history of OSA
• being overweight
• medical conditions such as Down syndrome or cerebral palsy
• problems of the mouth, jaw, or throat that narrow the airway
• a large tongue, which can fall back and block the airway during sleep

What Are the Signs & Symptoms of Obstructive Sleep Apnea?

When breathing stops, oxygen levels in the body drop and carbon dioxide levels rise. This usually triggers the brain to wake us up to breathe. Most of the time, this happens quickly and we go right back to sleep without knowing we woke up.

This pattern can repeat itself all night in obstructive sleep apnea. Because of this, people who have it don't reach a deeper, more restful level of sleep.

Signs of obstructive sleep apnea in kids include:

• snoring, often with pauses, snorts, or gasps
• heavy breathing while sleeping
• very restless sleep and sleeping in unusual positions
• bedwetting (especially if a child had stayed dry at night)
• daytime sleepiness or behavior/learning problems
• sleepwalking or night terrors

Because it's hard for them to get a good night's sleep, kids might:

• have a hard time waking up in the morning
• be tired or fall asleep during the day
• have trouble paying attention or be hyperactive

As a result, obstructive sleep apnea can hurt school performance. Teachers and others may think a child has ADHD or learning problems.

How Is Obstructive Sleep Apnea Diagnosed?

Talk to your doctor if your child:

• snores regularly
• is a restless sleeper
• falls asleep during the day
• has other signs of sleep apnea

Your doctor might refer you to a sleep specialist or recommend a sleep study.

A sleep study (also called a polysomnogram) can help doctors diagnose sleep apnea and other sleep disorders. Sleep studies are painless and risk-free, but kids usually need to spend the night in a hospital or sleep center.

During a sleep study, doctors check:

• eye movements
• heart rate
• breathing patterns
• brain waves
• blood oxygen levels
• carbon dioxide levels
• snoring and other noises
• body movements and sleep positions

How Is Obstructive Sleep Apnea Treated?

When obstructive sleep apnea is mild, doctors might check a child's sleep for a while to see if symptoms improve before deciding on treatment. Nasal sprays or other medicines may help some kids with mild OSA.

When big tonsils cause sleep apnea, doctors will refer families to an ear, nose, and throat doctor (ENT). The ENT might recommend:

• removing the tonsils (a tonsillectomy)
• removing large adenoids (adenoidectomy)
• removing both (adenotonsillectomy)

These surgeries often are effective treatments for obstructive sleep apnea.

For other causes, a doctor may recommend continuous positive airway pressure (CPAP) therapy. In CPAP therapy, a person wears a mask during sleep. The mask may cover the nose only or the nose and mouth. It's connected to a machine that pumps air to open the airways.

When excess weight causes obstructive sleep apnea, it's important to work with a doctor on diet changes, exercise, and other safe ways to lose weight. These patients often need CPAP to help them breathe during sleep.