New Statement About Sleep Apnea in Kids and Teens Released by the AHA
Last updated: January 2023
Last August, the American Heart Association (AHA) released a new scientific statement that summarized what’s known about obstructive sleep apnea (OSA) and other sleep-disordered breathing concerns in our youngest population: children and adolescents.1
Cardiovascular health in children with OSA was specifically addressed in the statement.
The AHA identified what they know about the impact of OSA in children’s health related to the risks for the following conditions:1
- High blood pressure (hypertension)
- Heart arrhythmias
- Abnormal heart structures (abnormal ventricular morphology)
- Impaired heart function (impaired ventricular contractility)
- Pediatric pulmonary hypertension (elevated right heart pressure)
They also summarized current best practices for diagnosing and evaluating complications of OSA in kids and teens related to cardiovascular disease and highlighted areas for future research.
Wait, children can have sleep apnea?
Yes! As many as 6 percent of all children and teens have OSA.2
That may seem like a small number, but the bigger issue is this: if it goes untreated during childhood, OSA can lead to a lifetime of chronic illness and become even harder to treat and control. Children with untreated OSA may potentially become adults with more than just OSA to contend with.
When kids live with untreated OSA, they also experience several negative impacts like adults do, including mental health issues, immune system dysfunction, and problems with metabolism, which can be extremely disruptive across the entire span of their development.1
Not only this but untreated OSA in our kids can lead to serious cardiovascular consequences that persist into adulthood.
OSA: Childhood’s hypertension gateway
For instance, children with early OSA persisting into their teen years have been found to be 3 times more likely than their non-OSA peers to have high blood pressure.3
High blood pressure is a kind of silent chronic illness “gateway.” If it remains undetected and untreated, it can lead to the development of other major health problems in children and young adults, including diabetes, stroke, and heart disease.
Metabolic syndrome describes the cluster of conditions that, especially when combined with obesity, are most likely to lead to the onset of 1 or more of these 3 major health problems.
This is a real problem, as between 30 and 60 percent of teens who are considered obese are also diagnosed with OSA.1
Unfortunately, even when kids have mild OSA, they have a higher risk for developing metabolic syndrome in early adulthood, according to data cited in the AHA statement.1
More than just swollen tonsils
Lead statement author Carissa Baker-Smith also addressed several other risk factors most often associated with childhood OSA. These include enlarged tonsils and/or adenoids, and facial structures that are still in development or are underdeveloped.2
It’s useful to note that the prevalence of OSA in children tends to peak between the ages of 2 and 8 years, which also happens to be the time kids are most likely to experience swollen tonsils.1
In addition, the AHA also identified 2 pediatric groups more likely to develop OSA as those:2
- With sickle cell disease
- Born prematurely (before 37 weeks)
Parents, keep an eye out for these symptoms
Perhaps most useful in the AHA statement is the symptom list that parents can review to determine whether their own children are at risk.
Symptoms of OSA in children include:1
- Snoring more than 3 nights per week
- Gasps or snorting noises during sleep
- Labored breathing while asleep
- Unusual sleeping positions (while seated or with a hyperextended neck)
- Daytime sleepiness
- Morning headaches
- Apparent upper airway obstruction (swollen tonsils, in example)
Parents may also want to check out the statement’s illustrations describing sleep-disordered breathing to better understand how increasing upper airway resistance can start out as common snoring but develop, over time, into full-blown OSA.
Finally, the statement also provides a useful vocabulary list to help demystify some of the medical jargon often used by doctors to describe OSA in kids and teens.
What if you suspect your child is at risk?
The AHA recommends that if parents are concerned a child might have OSA, they should talk to their pediatrician about getting a referral for a sleep study.2
In some cases, a sleep study may also be requested prior to the removal of tonsils in some children. This is because a pre-existing case of OSA in children with certain other conditions (for example, Down's syndrome) may put them at higher risk for complications while undergoing tonsillectomy.
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