A Word About Pediatric Sleep Apnea

If you think its ADD or ADHD affecting your child, you might want to reassess your child’s sleep first.

Childhood sleep apnea can occur at any age but commonly it becomes apparent between ages of 2 and 6 years of age.

It’s primarily caused by enlarged tonsils and adenoids which, during the younger ages, are most actively enlarging due to the child’s immune system becoming “hardwired” and programmed due to initial exposures to viruses, bacteria and antigens like molds and pollen. During sleep, especially valuable REM sleep, there is a decrease in muscle tone causing the airway to narrow. If the tonsils and adenoids are enlarged ( which in some children is constant) the airway collapses and becomes blocked. This blockage causes a chain of events that cause the child to wake up for short intervals due to lack of oxygen in the blood and brain. During these intervals, the child wakes up just long enough to resume breathing but not long enough to gain consciousness. This is why they don’t remember these episodes. These repeated awakening periods cause a fragmented sleep pattern which causes the the child’s body and brain to be “unrefreshed” leading to significant daytime problems, both physical and behavioral. This is why children with Obstructive Sleep Apnea are predisposed to being irritable, cranky, and frustrated more often . Most importantly they will become HYPERACTIVE, RESTLESS, EASILY DISTRACTED and HAVE DIFFICULTY PAYING ATTENTION and MAKING DECISIONS , acting confused as a result. These are also symptoms often attributed to ADD / ADHD which is a chronic behavioral disorder which sometimes requires a life time of different therapies including very strong pharmacological stimulants. Pediatric Obstructive sleep apnea is many times a reversible condition. You don’t want your child misdiagnosed.

So What are some of the objective signs of pediatric sleep apnea ? BE CAREFUL BECAUSE IT ISN’T ALWAYS OVERT SNORING. Many times it is as simple as very restless, contorting sleep and grinding of teeth. When the blood oxygen level gets dangerously low, the brain sends signals to the body to “get in in any position that opens the airway”. This is often an ached neck and back in almost a backward position. Grinding of teeth is the child’s brain sending the signal to ” push the jaw forward to pull the base of the tongue away from the throat”.

Other signs that your child might have apnea are frequent throat, nose and ear infections, obesity, unusually long sleep times , and excessive morning grogginess.

If your child exhibits this pattern of signs and symptoms they must be evaluated by their pediatrician or ENT specialist. They may prescribe an overnight Polysomnography Test or sleep test to determine if they have true obstructive sleep apnea or other sleep-related problems. If a positive test result, very often a simple out-patient surgical procedure, a Tonsil and/or Adenoidectomy provides a definitive abatement of the airway obstruction leading to a significant and drastic improvement in the child’s quality of life and performance in school.