This page discusses uncomplicated childhood sleep apnea.
The American Academy of Pediatrics defines uncomplicated sleep apnea as
obstructive sleep apnea in an otherwise healthy child,
caused by any or all of:
Snoring is an important sign of uncomplicated childhood sleep apnea.
The American Academy of Pediatrics recommends that all children
be routinely screened for snoring.
Asking parents is the usual method of screening. Children who snore
should be evaluated further.
- enlarged tonsils
- enlarged adenoids
It is important to diagnose sleep apnea in children because the
The effects of treatment can be dramatic.
About 2% of children have sleep apnea, or 1 in 50.
Snoring occurs in 3% to 12% of children of pre-school age.
Sleep apnea in children can cause:
One or more of these consequences of sleep apnea may be absent in
some children, mild in some, and severe in others.
Death from sleep apnea has occurred.
- Behavioral and mental effects, including:
- excessive sleepiness during the day
- hyperactive behavior
- other behavioral disturbances
- decreased school performance
- mental retardation (in severe, untreated cases)
- Cardiovascular effects, including:
- High blood pressure
- High blood pressure in the lungs ("pulmonary hypertension")
- Abnormal heart function
- Diminished growth
- Re-shaping of the ribs
- Bed wetting
- Worsening of co-existing medical conditions, including
The behavioral effects of sleep apnea in children can be different from
those in adults. Some children with sleep apnea have behaviors
that are indistinguishable from attention deficit/hyperactivity disorder.
Surgical removal of the tonsils and adenoids is the first-line treatment
for most children. The success rate
is 75% to 100%, even if the child is obese.
Children who undergo surgery should be evaluated afterwards, to determine
the effectiveness of the operation.
Effects of Treatment
When surgery fails or is inadequate, it is possible to use breathing masks of
the type used to treat adults.
The American Academy of Pediatrics notes that childhood sleep apnea
"can result in severe complications if left untreated.".
References and Notes
For most, if not all, of the sleep apnea consequences listed above,
there is at least some evidence that treating sleep apnea leads
For example, a remarkable study from New Orleans showed that treating sleep apnea
in academically poor first graders leads to improved grades in school
the next year.
Improvement is thought to be more likely the earlier
the disease is diagnosed and treated.