Sleep Apnea in Children

Reviewed by: HU Medical Review Board | Last reviewed: June 2020 | Last updated: February 2024

Many people think sleep apnea only happens to overweight men or old people. But, children can have sleep apnea too. Just like in adults, children may have obstructive sleep apnea (OSA) if they snore every night, or gasp, snort, and stop breathing during sleep.1-3

Experts believe that 2 to 3 percent of children have sleep apnea. The rate is much higher in children who snore often, with as many as 10 to 20 percent having sleep apnea. It is most common in children between the ages of 2 and 8.3,4

What causes sleep apnea in children?

Our muscles relax when we sleep, including the muscles in the back of the throat. These muscles keep our airway open so we can breathe. In people with sleep apnea, these muscles relax too much.3

Being born with a narrow airway can make sleep apnea more likely. Infections and inflammation that cause the tonsils and adenoids to get bigger can also cause sleep apnea. A child may also snore only when they have a cold or flu. This is probably not sleep apnea. Other conditions that make sleep apnea more likely include:3,4

  • Being overweight
  • Down syndrome
  • Cerebral palsy
  • A large tongue
  • Physical problems of the mouth, jaw, or throat that cause these areas to be too small

Signs of sleep apnea in children

Like adults, children with sleep apnea often snore, snort, gasp, and stop breathing for short periods while asleep. But sleep apnea may look different in children. They may also:1-4

  • Have restless sleep
  • Breathe very heavily
  • Sleep in unusual positions
  • Sleepwalk
  • Have night terrors
  • Wet the bed, especially if they previously stayed dry at night

Because they are not getting restful sleep, children may also have a hard time waking up or might fall asleep during the day. This is called excessive daytime sleepiness. Children are more likely than adults to have behavior problems, hyperactive attention deficit disorder (ADHD), and concentration problems in school.1-4

Some studies suggest that 1 in 4 children who are diagnosed with ADHD may actually have sleep apnea. Childhood obesity is also tied to undiagnosed sleep apnea.4,5

Diagnosing sleep apnea in children

If a caregiver notices their child snoring regularly, a talk with the pediatrician is in order. The doctor may ask about other signs of sleep apnea. You may need to see a sleep specialist or go to a sleep lab for an overnight sleep study.1,3

Treating sleep apnea in children

Treatment for sleep apnea in children will depend on the cause. If the sleep apnea is mild, your doctor may want to wait and see if symptoms get better after some time. However, sleep apnea should be treated if it continues because it can lead to learning problems and obesity.3

If big tonsils or adenoids are the cause, your doctor may recommend removing them. This is the most common treatment for children with sleep apnea. Removing the tonsils is a surgery called a tonsillectomy. Removing the adenoids and tonsils is a surgery called an adenotonsillectomy. This surgery stops the problem in most cases.3,4

Your doctor may recommend your child use a CPAP machine at night. CPAP stands for continuous airway pressure. This machine pumps air through a mask that the person wears while asleep. Masks come in designs that are more appealing to children. Other treatments include cold and allergy medicines for children with allergies or medicine.2,3

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