How Do You Know If You Have Sleep Apnea?

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

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

The most common culprit 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

The two types of sleep apnea are:

• Obstructive sleep apnea
  This 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 occasional may awaken up 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

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 apneas.

Why? 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 at night. 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.

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.

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. Following evaluation by our Sleep Disorders specialist treatment options may include:

• Topical or oral medications
  Topical nasal steroids, like 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 mouth) can sometimes be expanded with use of dental devices. These devices are used to expand the palate and open the airway in children. Palatal expansion may be of especial value if 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 left untreated, sleep apnea can lead to more serious health problems like high blood pressure, heart disease, type 2 diabetes, stroke later in life. During childhood, problems include poor school performance and hyperactivity. 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.