Obscure Symptoms of Obstructive Sleep Apnea in Children

“Obstructive sleep-disordered breathing is common in children. From 3 percent to 12 percent of children snore, while obstructive sleep apnea syndrome affects 1 percent to 10 percent of children.”[1] Many parent are aware of common signs of obstructive sleep apnea; snoring, gasping sounds, choking sounds, bedwetting, sleep talking, sleep walking, hyperactivity. Many are not aware of the obscure everyday sleeping issues children have that may be caused by obstructive sleep apnea (OSA).

 

Hyperactivity and mild ADHD is one symptom of OSA that is often overlooked by parents. A sleep study in Arizona explored this. “The sleep studies divided the children into four groups: those who never had sleep-disordered breathing, those who had it the first time but not the second, those who had it only the second time (new onset), and those who had it both times (persistent). The results showed that children with new onset sleep apnea were at least four times as likely to have behavioral problems- the likelihood rose to six times higher if they had persistent sleep apnea.”[2]

 

Another symptom of OSA is sleepwalking and sleeptalking. Many doctors state that sleepwalking and talking occur more in children who have sleep apnea. “The prevalence of sleepwalking is much higher for children, especially those between the ages of three and seven, and occurs more often in children with obstructive sleep apnea.”[3] But no one seems to know why.

 

Bedwetting or nocturnal enuresis is another symptom of OSA that is usually overlooked. This may be due to the fact the body is focusing on trying to breath, so less important functions, like bladder control are forgotten. However, there are many other causes of bedwetting. Other symptoms should be considered.[4]

 

Treatment of OSA in children is just as important as in adults. “If left untreated, obstructive sleep apnea can cause poor growth (“failure to thrive”), high blood pressure, and heart problems. Obstructive sleep apnea can also affect behavior and cognition.”[5]

 

Treatment of OSA in children includes:

  1. Maxillofacial Orthopedics (RPE – maxillary jaw expansion with reverse pull face mask) [7]
  2. Surgery to remove the tonsils (tonsillectomy) and / or the adenoids (adenoidectomy). An ear, nose and throat specialist will need to be consulted to determine the need for such surgeries.
  3. Craniofacial abnormalities (disfigurement of the facial and skeletal bones) also require a different form of surgery.
  4. Weight loss and exercise may also be recommended.
  5. Continuous Positive Air Pressure (CPAP) can be used if surgery is not an option.[6]

 

 

  1. Obstructive Sleep Apnea in Children. http://www.aafp.org/afp/2004/0301/p1147.html
  2. Sleep Apnea in Children:Effects May Include ADHD, Learning Problems. http://www1.ccsdc.net/sleep-apnea-in-children-effects-may-include-adhd-learning-problems/
  3. Sleep Walking / Talking. http://www.sleepmanagement.md/sleepdisorders/sleepwalking.aspx
  4. Pediatric Sleep Disordered Breathing / Obstructive Sleep Apnea. http://www.entnet.org/content/pediatric-sleep-disordered-breathingobstructive-sleep-apnea
  5. Obstructive Sleep Apnea. http://www.chop.edu/conditions-diseases/obstructive-sleep-apnea#.VZyZq_lViko
  6. Obstructive Sleep Apnea. http://www.chop.edu/conditions-diseases/obstructive-sleep-apnea#.VZyZq_lViko
  7. Obstructive Sleep Apnea Orthodontic Maxillary & Mandibular Expansion. http://www.pedsleep.org/Portals/1/IPSA%20Online%20Textbook/Guilleminault_PedOSAS%202005.pdf

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