The Long-Term Effects of Childhood Sleep Apnea

Sleep apnea is a condition that is generally associated with adults, but children can also be affected. The condition, which causes short pauses in breathing during sleep, has side-effects including daytime drowsiness and lack of concentration -- and has also been associated with behavioral issues among children.

There are two variants of sleep apnea, namely central sleep apnea (CSA) and obstructive sleep apnea (OSA). Central sleep apnea is usually put down to poor or weak inhalation of air while obstructive sleep apnea is often caused by a physical blockage in the air passage during sleep.

Of the two types, OSA is by far the most prevalent in both adults and children. Researchers are currently studying the long-term effects of childhood sleep apnea -- and how the condition might affect physical and mental well-being in later life.

Causes of Childhood OSA

There is no singular cause of obstructive sleep apnea in children, but the condition is more likely to occur in certain circumstances. 

These include difficulty with:

Adenoids and tonsils. The adenoids and tonsils, located at the back of the throat, can become enlarged for a variety of reasons including inflammation, infection and genetics. When this occurs the airway is restricted which makes breathing difficult and particularly so during sleep.

Weight. Overweight children are more likely to suffer from some form of sleep apnea and this is particularly true for children clinically termed as obese.

There are other factors that may put some children more at risk of suffering sleep apnea. Some are physical and some are medical. These include:

Dental issues such as an overbite or small jaw size

Medications including opioids and sedatives

Weak throat or tongue muscles (associated with cerebral palsy and Down syndrome)

Nasal allergic reactions to pollen, dust etc.

Being subjected to secondhand cigarette smoke in the home

Another risk factor that commonly crops up is a family history of sleep disorders.

Signs and Symptoms

Probably the most common indicator of possible OSA is persistent snoring. Everybody, including children, snores occasionally but when this becomes a regular occurrence it may be an early warning sign of possible sleep apnea. 

Snoring, however, is not the only common sign or symptom of sleep apnea as there is a multitude of possible indicators that children may exhibit:

Breathing predominantly through the mouth

Fits of choking or coughing at night

Night sweating

Sleepwalking

Talking while asleep

Night terrors

Bed wetting

These symptoms all affect children during sleep, but there are also daytime issues that may indicate a possible case of sleep apnea:

Daytime drowsiness

Lack of concentration

Morning headache

Irritability

Mood swings

Some children with undiagnosed OSA are often incorrectly presumed to suffer from ADHD (attention deficit hyperactivity disorder) as the condition can also cause typical ADHD symptoms like impulsiveness, rebelliousness and hyperactivity.

Because sleep apnea in children is generally unexpected, it is often left undiagnosed or misdiagnosed. A child displaying any, some or all the recognized symptoms of OSA should always be checked thoroughly by a doctor or sleep specialist.

Diagnosis and Treatment

Diagnosing possible obstructive sleep apnea in a child follows the same basic procedure as the process for adults. 

The doctor will collect as much information as possible from the parents regarding sleeping habits as well as details of any daytime or nighttime symptoms that may be evident. A physical examination of the throat, neck and mouth will also likely be carried out to check for possible physical causes.

Further testing may include a sleep study which is carried out overnight at a specialist clinic. The study measures bodily functions during sleep and provides definitive results which are used for diagnostic and treatment purposes.

Treatment for OSA will depend on the underlying cause and the severity of the condition. If the problem can be traced back to obesity it may just be a matter of changing lifestyle to include more physical exercise and following a healthy, balanced diet.

If, however, the cause is physical the treatment will reflect this fact. A dental issue may require some form of corrective surgery while a physical problem may also need surgical intervention. 

Surgery is a rare occurrence, and most cases can be successfully treated or controlled using more conventional methods. These can include nasal steroids or the use of positive airway pressure (PAP) devices which keep the airway free of obstruction during sleep.

Long-Term Effects of Childhood Sleep Apnea

As is the case with OSA in adults, it is always best to have the condition properly diagnosed and treated rather than simply ignoring it. Untreated obstructive sleep apnea has been strongly linked to serious physical conditions including heart disease and diabetes and, at the very least, it can significantly lower overall quality of life.

For children it can also mean losing out on education as the concentration levels can be greatly reduced and there may be a general disinterest in sporting activities and in social engagement. Sleep apnea is more than just an annoying condition because it can have a lasting impact on a child's physical, emotional and intellectual development.

For these important reasons, it is something that should always be investigated if the signs and symptoms of possible obstructive sleep apnea appear. Waiting and hoping for a miracle cure is not an option if the child's best interests and well-being are what really matters as they always should be!

SOURCE:

https://www.sleepfoundation.org/sleep-apnea/children-and-sleep-apnea