Thursday, May 15, 2008

Kids and Sleep Apnea

This week in our "helping kids sleep" series, I thought we should mention sleep apnea. Reader Jennifer emailed me saying "My son is a mouth breather, does that effect sleep?

Pediatric Sleep Specialist Dr. Sarah Zallek said mouth breathing can be a sign of obstructive sleep apnea, the most common medical problem she sees in her practice. She said, "So, mouth breathing can be a sign of a tendency toward sleep apnea because of upper airway narrowing. It can also be a cause of some sleep apnea because of the way the jaw can relax and collapse the airway."

Here's the definition of sleep apnea according to the American Sleep Apnea Association:

"There are three types of apnea: obstructive, central, and mixed. The most common is obstructive sleep apnea. Obstructive sleep apnea is caused by a blockage of the airway, usually when the soft tissue in the rear of the throat collapses and closes during sleep.

In central sleep apnea, the airway is not blocked, but the brain fails to signal the muscles to breathe. Mixed apnea, as the name implies, is a combination of the two. With each apnea event, the brain briefly arouses people with sleep apnea in order for them to resume breathing, but consequently sleep is extremely fragmented and of poor quality."

My son was diagnosed with obstructive mouth breathing a month and a half ago. He consistently wakes up at night. One of the main treatments for obstructive sleep apnea is a tonsillectomy, adenoidectomy or both. My four year had the surgery a month ago.

Here are the links to those posts:

Tonsillectomy Recovery

Tonsillectomy/Adenoidectomy Surgery Day

The last few days he seems to be doing better. He is waking up twice a night screaming instead of 6-8 times a night. So, I am hopeful he will sleep through the night at some point. I can't say whether having the surgery cured him. I am not necessarily convinced he had sleep apnea in the first place.

"More than twelve million Americans have sleep apnea, according to the National Institutes of Health. Risk factors include being male, overweight, and over the age of forty, but sleep apnea can strike anyone at any age, even children. Yet still because of the lack of awareness by the public and healthcare professionals, the vast majority remain undiagnosed and therefore untreated, despite the fact that this serious disorder can have significant consequences.

Untreated, sleep apnea can cause high blood pressure and other cardiovascular disease, memory problems, weight gain, impotency, and headaches. Moreover, untreated sleep apnea may be responsible for job impairment and motor vehicle crashes. Fortunately, sleep apnea can be diagnosed and treated. Several treatment options exist, and research into additional options continues. "

Symptoms of Sleep Apnea: from
  • Although snoring is a common symptom in children with obstructive sleep apnea, it is important to remember that between 10-20 percent of normal children snore (primary snoring) on a regular or intermittent basis.
  • failure to thrive (weight loss or poor weight gain)
  • mouth breathing
  • enlarged tonsils and adenoids
  • problems sleeping and restless sleep
  • excessive daytime sleepiness
  • daytime cognitive and behavior problems, including problems paying attention, aggressive behavior and hyperactivity, which can lead to problems at school

Treatment of Sleep Apnea:

I also found a quiz that is supposed to tell you whether you suffer from sleep apnea. You can find it at the American Sleep Apnea Association.

Here are the links to the other stories I have covered on the blog dealing with sleep and kids:

How many hours of sleep do kids need?

"The Sleep Fairy" Book for toddlers

Older kids losing sleep when new baby arrives

Do you or your kids suffer from sleep apnea?

-NewsAnchorMom Jen


Jennifer said...

Wow. Now I'm really hoping his "mouth breathing" during sleep isn't indicative of sleep apnea, that's really scary!
And, he was going to have his tonsils out a few years ago, due to several bouts of strep in one year, but we ultimately decided against a tonsillectomy, but now I wonder if we should have had it done, it might have helped with the mouth breathing issue. said...

I'm no doctor, but it sounds like it might be worth asking a specialist. My son is breathing a whole lot better and he no longer snores. The tonsillectomy was not fun though! I don't blame you for not doing it. There is no guarantee it will help!
When the nurse practitioner walked in the room he could tell right away that my son as a mouth breather. I never realized it was that obvious.

Maria said...

My son suffers apnea, but his ped said to wait until he was 18 months or so to see what happens. a lot of babies have it and outgrow it. At his next ENT appointment though, around that 18 month mark, I will ask the specialist his thoughts. The thing with The Boy's is that sometimes it is worse than others-- i.e. when his allergies are acting up or he has a cold.

Shannon said...

My son had a sleep test when he was almost 2 because I was concerned about his snoring. (He was rivaling my husband.) They found just 9 episodes of apnea - which our ped. at the time said was pretty low. Although, they were not obstructive episodes, which to me was more scary although again, our ped. at the time seemed unconcerned.

Now he's 7 and rarely snores at all.

Don't know that I necessarily have a point... just sharing our experience.

Maria said...

So... 18 months and an ENT visit later, we find out The Boy has enlarged adenoids. Decision time... said...

Is it just his adenoids or his tonsils too? I feel your pain! That was a really tough decision for us! email mke if you want to talk!

Maria said...

Doc says the tonsils look fine, but that once his tubes come out (grrr...another story, yet related), with the adenoids the way they are, he will probably need them again. The question is whether or not to wait and see if he can tolerate the adenoids without the tubes (and put tubes back in when adenoids come out) or to get the adenoids out this summer. WAit or action. Hard call... I'm still doing research.

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