Sleep apnea in children and adults is where there’s an irregular breathing pattern during sleep. Someone suffering from apnea will appear to stop breathing for a short period of time before gasping and continuing to breathe normally – and this can happen continually during the night. While the condition itself isn’t serious, it can cause a temporary lack of oxygen, and and sleep apnea in children can lead to daytime drowsiness and even behavioural problems.
Types of Sleep Apnea
There are three types of sleep apnea. The most common is Obstructive Sleep Apnea. This is where there is a physical blockage in the respiratory system – in children, this is usually enlarged tonsils or adenoids. Symptoms include snoring that ends with a gasp for breath, laboured breathing during sleep and restlessness in the night. Children with Obstructive Sleep Apnea may sleep in strange positions to try to relieve the obstruction. Treatment is normally through surgery to remove the tonsils and/or adenoids, though nasal medication to open the passageways can help. Monitoring devices can be used to keep track of breathing patterns – an alarm can wake a sleeping child if they stop breathing for too long – and sleep therapy can be useful too.
The second type of sleep apnea in children is Central Apnea and this is a problem in the part of the brain that controls breathing. It’s common in premature babies, where it’s known as Apnea of Prematurity (AOP), because their brain and respiratory system is likely to be immature and not quite working properly. Babies with AOP normally remain in hospital until they are breathing more regularly, having extra oxygen through a CPAP nose mask, and then may be sent home with an apnea monitor and some CPR training for the parents.
There’s also Apnea of Infancy (AOI) which is seen in full term babies under a year of age. This is where breathing is obviously irregular but an assessment for Obstructive Sleep Apnea finds no physical cause. Often a child will grow out of it and sometimes it can just be that a baby’s “natural” breathing pattern is irregular. An apnea monitor and training in CPR can be reassuring for parents.
Mixed Sleep Apnea is a combination of Obstructive and Central Sleep Apnea. The cause is not known but sometimes a long-standing case of Obstructive Apnea can cause changes to the brain, affecting the breathing during sleep. Treatment can include medication, surgery and oxygen therapy.
Finally, a condition called Apparent Life-Threatening Event (ALTE) involves sleep apnea and can be very frightening for parents. This is where a combination of sleep apnea, choking or gagging, limpness and a change in skin tone leaves a child looking lifeless. It’s normally related to other medical conditions and is not normally serious but can be very scary to see. If you suspect your child is having an ALTE you must call 999 immediately.
If you are concerned about your child’s breathing when they are asleep speak to your GP. They will arrange an assessment to determine the causes and relevant treatment. I strongly advise that you do not attempt to try any sleep training techniques if you suspect your child is suffering from Sleep Apnea until you have sought medical advice.