We know that anywhere from 8% to 12% of children snore most nights. This is called habitual snoring. We also know that 3% to 5% of children have sleep apnea. Pediatric sleep apnea is a serious condition that can adversely affect your child’s growth, emotional and cognitive development, and cardiovascular health. Here are 10 tips that should help you decide whether your child’s snoring might need further medical evaluation.
1. Frequent nighttime sweating. This is due to overactivity of the sympathetic (fight or flight) nervous system during sleep, triggered by low oxygen and efforts to breathe against a closed airway.
2. Paradoxical inward movement of the rib cage and sternum (breastbone) while breathing in. Again caused by vigorous efforts to breathe in against a closed airway.
3. Assuming unusual positions while asleep. Hyperactive extension of the neck is common in children with sleep apnea. It tends to help keep the airway open.
4. Morning headaches. These are due to low oxygen and elevated blood pressure while asleep.
5. Chronic bedwetting. Several studies have shown a high incidence of sleep apnea in bedwetters. In one recent study, 42% of a group of children treated for sleep apnea were bedwetters. After treatment, 66% showed significant improvement.
6. Hyperactivity and inattentiveness in school. Children with sleep apnea are frequently misdiagnosed as having ADHD. Careful screening such as inquiring about snoring can in some cases avoid unnecessary medications used for ADHD.
7. Frequent sleepwalking and night terrors. Sleep apnea can cause this. In fact, in a study done at Stanford several years ago, a majority of sleepwalking children with sleep apnea stopped sleepwalking after treatment of their sleep apnea.
8. Pediatric hypertension. All children with hypertension should be screened thoroughly for the presence of sleep apnea.
9. Down syndrome. The incidence of sleep apnea has been reported to be anywhere from 40% to 70% of all children with Down syndrome. Untreated, it can severely affect their health and mental development.
10. Obesity. Recent studies have shown that as many as 30% of obese children may have sleep apnea. Untreated, associated sleep apnea increases their already high chances of developing hypertension, insulin resistance, and associated metabolic disorders. It also hinders the child’s ability to lose weight.
Therefore, the take home message is that sleep apnea is becoming even more common but it can be easily treated in most children. Untreated, it may have numerous undesirable effects on health and development. Consequently, if your child snores chronically or has any of the other aforementioned signs or symptoms, be sure to bring it to the attention of your health care provider.
