What is Sleep Apnea?
Sleep Apnea is a term used to describe periods of sleep where breathing is either not occurring (central apnea) or the flow of air is blocked (obstructive apnea). Pediatric sleep apnea can range from simple snoring without blockage of the airway to severe blockage of the airway with prolonged pauses. Pauses and periods of obstruction can lead to drops in blood oxygen levels, arousals from sleep and fragmented sleep. These obstructive symptoms occur during sleep more frequently because breathing is slower and shallower and muscle tone decreases.
Factors that can influence sleep apnea:
- Increased tonsil and adenoid size
- Enlarged inferior turbinate tissue in the nose, severe deviation of the nasal septum, nasal polyps or congenital narrowing of the nose (pyriform aperture stenosis)
- Obstruction due to the back of the tongue (tongue base) falling against the back wall of the throat
- Decreased muscle tone collapsing the voice box
- Congenital changes in their facial structure (craniofacial abnormalities)
- Decreased muscle tone (hypotonia), including Down syndrome
- Overweight children
What are Symptoms of Sleep Apnea?
Symptoms of sleep apnea may include snoring, mouth-breathing when asleep, frequent awakening during the night and restless sleep (tossing and turning). Also, your child may sleep walk or sleep talk. During the day, children who have sleep apnea may be difficult to awaken, excessively sleepy , hyperactive or have behavioral issues.
What Tests are Done?
If your child is experiencing these symptoms, a careful examination of your child’s nose, mouth and throat can reveal the source(s) of potential blockage. Additional testing either during an office visit or in a separate setting also may be recommended. Tests include a fiber optic camera examination of the portions of the nose and throat not able to be seen with standard in-office examination, a sleep study (polysomnogram) or a sedated procedure called sleep endoscopy. These additional tests may be necessary to help to determine the amount and location of obstruction in your child and to determine if surgery would help to improve your child’s sleep apnea.