How Do You Know If You Have Sleep Apnea?

Medically reviewed by Dennis H. Nicholson, MD, Medical Director, PVHMC Sleep Disorders Center

Sleep apnea is a potentially serious medical disorder that affects between 50 and 70 million adults in the United States and could affect an estimated 10 percent of children, according to the American Academy of Family Physicians.

Sleep apnea occurs when a person’s breathing is repeatedly blocked during sleep. Blockage of the airway causes snoring and, if severe, can cause low oxygen, elevated blood pressure, and damage to the brain and heart over time. Sleepiness, fatigue, depression, and loss of sexual drive can also result.

Pediatric (childhood) Sleep apnea is a potentially serious sleep disorder.  If your child regularly feels tired after a full night of rest, has trouble with hyperactivity, poor school grades, or difficulty paying attention in class, you may want to talk to your doctor about a sleep disorder evaluation.

If left untreated, sleep apnea can lead to more serious health problems like high blood pressure, heart disease, type 2 diabetes, and stroke later in life. During childhood, problems include poor school performance and hyperactivity.

Sleep apnea may be the culprit if your loved one snores and feels tired or sleepy after a full night’s rest.

Common symptoms of sleep apnea

Many factors can lead to Sleep Apnea and snoring, including excess weight, problems with a small air passage, a receding jaw, or other issues with the airway. Excess weight is commonly associated with sleep apnea snoring. When an overweight or obese person sleeps, their throat and tongue muscles become more relaxed, closing off the upper passages of their airway.

Loud, repetitive snoring isn’t only a nuisance, it’s one of the main indicators of sleep apnea. Here are three main indicators of obstructive sleep apnea:

1. Loud, persistent snoring
2. Pauses in breathing, along with gasping attacks while sleeping
3. Excessive sleepiness while awake
4. Morning headaches
5. Difficulty paying attention
6. Irritability
7. Auto accidents

It is important to note that many people who snore do not have obstructive sleep apnea; however, most people who have sleep apnea snore.

Common risk factors of sleep apnea

Sleep apnea is often a byproduct of other health factors, including:

• Excess weight
  Fat deposits in and around the upper airway may obstruct breathing.
• Neck circumference
  Surprisingly, those with thicker necks may have narrower airways.
• Narrow airway
  A narrow throat, enlarged tonsils, or adenoids may also block the throat.
• Gender
  Men are two to three times more likely to have sleep apnea than women before menopause. After menopause, women are as likely as men to suffer from sleep apnea.
• Age
  This disorder is most common in older adults.
• Genetics
  A family history of sleep apnea may increase your risk.
• Alcohol or drug use
  These substances relax the throat muscles, which can worsen obstructive sleep apnea.
• Smoking
  Smokers are three times more likely to struggle with sleep apnea.

The most common culprits in children are enlarged tonsils or adenoids. Childhood obesity can cause or contribute to Obstructive Sleep Apnea.

If you notice your child snores or breathes loudly during sleep, the board-certified physicians at Pomona Valley Health Centers encourage you to visit our Sleep Disorders Center to help your child get better, healthier sleep.

Types of sleep apnea

There are two types of sleep apnea:

• Obstructive sleep apnea (OSA)
  OSA is the most common type of sleep apnea and occurs when the muscles in your throat intermittently relax and block your airway during sleep. Children with OSA may be transiently aroused from sleep and occasionally awaken for a few seconds to gasp for air. In severe cases, brief arousals can happen hundreds of times a night.
• Central sleep apnea:
  Central sleep apnea occurs when your brain doesn’t send correct signals to the muscles in your throat that control breathing. This condition also causes breathing to start and stop repeatedly during sleep. If left untreated, this condition may adversely affect your heart health. Central sleep apnea is much less common in children except in premature or term infants.

Common allergies that may increase sleep apnea risk

While nasal allergies may not specifically cause sleep apnea, there does seem to be a connection. Those with allergic rhinitis (e.g. hay fever) have a higher risk of experiencing longer and more frequent obstructive sleep apnea.

People who suffer from seasonal allergies experience heightened symptoms at night, which can trigger sleep apneas. Warm temperatures push pollen and other common allergens like mold spores, dust, and pet dander into the air, but cooler air at night means these allergens fall back down and cover surfaces.

Labored breathing occurs when the upper airway narrows as a result of congestion. This can lead to more frequent breathing disruptions, which interrupt the body’s natural sleep cycles and leave your child irritable and tired. Inflammation can also create a buildup of pressure that contributes to headaches, teeth grinding, and an increased risk of repeated apneas.

If your child collects pollen (or other allergens) in their hair or clothes over the course of the day, it can increase their risk of bedtime allergy and sleep apnea symptoms. This combination can leave them struggling to get the restorative sleep they need.

How to avoid sleep apnea emergencies

Sleep apnea could put you or your child’s life at risk, so it’s important to understand how to manage it and alleviate severe symptoms. Your doctor will work with you to determine the best treatment for your child’s sleep disorder. After an evaluation, our Sleep Disorders Specialist might recommend the following treatments:

• Topical or oral medications
  Topical nasal steroids might ease sleep apnea symptoms for some children with mild obstructive sleep apnea. For kids with allergies, Singulair has been known to help relieve symptoms and may be used with nasal steroids.
• Tonsils and adenoid removal
  For moderate to severe sleep apnea, your doctor may recommend removing the tonsils and adenoids to help improve obstructive sleep apnea. The procedure opens the airway and is performed by an ear, nose and throat specialist.
• Evaluation of the palate and dental condition.
  A narrow hard palate (roof of the mouth) can sometimes be expanded with the use of dental devices. These devices are used to expand the palate and open the airway in children. Palatal expansion may be of special value if an Adeno-tonsillectomy fails to resolve OSA (about 15% of patients)

• Positive airway pressure therapy.
  Either a continuous positive airway pressure (CPAP) or a bilevel positive airway pressure (BPAP) machine may be recommended for more severe cases of sleep apnea. These small machines gently blow air through a tube and mask attached to your child's nose, or nose and mouth. The machine pushes air into the back of your child's throat to help keep it open. Doctors commonly use this method when medications or removal of adenoids and tonsils is not effective.

If you or your child is struggling with symptoms of sleep apnea or other sleep disorders, please contact Pomona Valley Health Centers at 909-378-9025. Our Sleep Disorders Center, located in Claremont, CA, offers state-of-the-art facilities and easy access to comprehensive, caring medical services.