By Sandeep P. Davé, MD, Chief, Section of Pediatric Otolaryngology, Nicklaus Children’s Pediatric Specialists

Most people think of obstructive sleep apnea as a condition that impacts adults. While it is true that somewhere between 2 and 9 percent of adults have sleep apnea (according to the Sleep Foundation), they are not the only ones who are affected. In my experience as a pediatric otolaryngologist, I have seen my fair share of obstructive sleep apnea cases in infants and children, as well.

Although obstructive sleep apnea is less common in children, it is still a risk that I believe parents should be aware of. The Sleep Foundation estimates that between 1 and 5 percent of children are affected by it, and that it may be underdiagnosed. With that in mind, I compiled this list of sleep apnea warning signs for parents to be on the lookout for in your children. If you notice any combination of the symptoms below, then it might be worth a discussion with your child’s pediatrician.

1) Enlarged Adenoids and Tonsils

The most common conditions that cause obstructive sleep apnea in children are swollen adenoids and tonsils. These glands located near the back of the throat frequently become enlarged in children, which in turn can narrow the airway and make it difficult for children to breathe while they are asleep.

If your child experiences frequent sore throats or swollen tonsils and adenoids, then you will want to speak to your child’s pediatrician not only about the risks of sleep apnea, but also about the possibility of having the tonsils and adenoids removed. It is a common procedure that brings relief to many children who experience these symptoms.

2) Snoring and Unusual Breathing While Asleep

Another category of warning signs for childhood sleep apnea include symptoms related to unusual sleep-time breathing. This, of course, is most commonly noticed with snoring, but snoring alone is not necessarily a sign that a child has apnea.

If snoring is accompanied by other unusual breathing patterns during sleep, this is a greater indicator of possible sleep apnea. Signs to look for include:

• Pauses or interruptions in breathing
• Mouth breathing
• Coughing
• Choking

3) Restless Sleep, Sweating, Bedwetting or Sleep Terrors 

Children with obstructive sleep apnea are also more likely to exhibit other unusual behaviors during sleep, including the following:

• Tossing and turning
• Sleepwalking or sleep talking
• Night terrors
• Wetting the bed

4) Obesity or Poor Weight Gain

Just as in adults, there is a strong connection between obstructive sleep apnea and obesity in children. This connection often occurs because obesity can lead to narrowing of the airway. The Sleep Foundation estimates that 60 percent of obese children also have obstructive sleep apnea. In some children, poor weight gain may also be a sign of sleep apnea.

5) Problems with Attention, Behavior or School Performance 

Unfortunately, the poor quality of sleep that impacts children with sleep apnea frequently leads to difficulties during the daytime. For example, it is common for children with obstructive sleep apnea to have trouble paying attention and retaining information. As a result, they often perform poorly in school. Children with sleep apnea may also have other behavioral problems, including hyperactivity, irritability and trouble controlling their emotions.

The Bottom Line on Childhood Sleep Apnea

If you notice any combination of these symptoms in your children, then it is certainly worth a discussion about sleep apnea with your child’s pediatrician. There are several options for treating sleep apnea and in many cases, childhood sleep apnea can be relieved with a surgery to remove the tonsils and adenoids. Other treatments range from weight loss to allergy treatments to the use of a CPAP machine. Most cases of childhood sleep apnea can be successfully managed by working closely with your child’s pediatrician and a pediatric otolaryngologist.

Why Choose Nicklaus Children's ENT?

You want the best and most experienced team when your child requires medical care or surgery. Here’s why you should choose Nicklaus Children’s:

• We are the number one center in South Florida for surgery to remove adenoids (adenoidectomy) and tonsils (tonsillectomy).
• We have four of the Top 10 pediatric otolaryngology/ENT surgeons in South Florida.*
• Our team performed 52% of all the pediatric (0-21 years of age) adenoidectomy and tonsillectomy surgeries in South Florida (Broward, Collier, Lee, Miami-Dade, Monroe and Palm Beach counties) last year.*
• Adenoidectomies and tonsillectomies comprise 54% of all the otolaryngology/ENT surgeries conducted at a Nicklaus Children’s facility.**