Sleep apnoea living in children

Overview

Sleep apnoea is a condition where a child’s breathing stops and starts repeatedly during sleep. The most common type in children is obstructive sleep apnoea (OSA), caused by a blockage in the airway, often when the throat muscles relax.

Yes, sleep apnoea is fairly common in children, especially between ages 2 and 8 when tonsils and adenoids are largest.

It mainly affects young children, but also those who are overweight, have certain medical conditions (like Down syndrome), or have a family history of sleep apnoea.

Symptoms

Common symptoms

• Loud snoring
• Pauses in breathing during sleep (often noticed by a parent)
• Gasping or choking sounds during sleep
• Restless sleep or unusual sleeping positions
• Daytime sleepiness or irritability

Symptoms in children

• Snoring that is loud and consistent
• Breathing pauses followed by a gasp or snort
• Bedwetting (especially if they were previously dry at night)
• Hyperactivity, difficulty paying attention, or poor school performance
• Mouth breathing, often with a dry mouth in the morning
• Sleeping with the head tilted back or in unusual positions

Symptoms in older adults

• This article focuses on children, but in older adults sleep apnoea often causes loud snoring, daytime sleepiness, and morning headaches.

Causes

Main causes

• Enlarged tonsils or adenoids (the most common cause in children)
• Obesity or excess weight
• Narrow airway from birth or due to other conditions

Risk factors

• Being overweight or obese
• Having a family history of sleep apnoea
• Certain medical conditions like Down syndrome, cerebral palsy, or cleft palate
• Allergies or sinus problems that cause nasal congestion

When to see a doctor

See a doctor urgently if:

• Your child has pauses in breathing that last longer than 10 seconds
• You notice your child turns blue or has trouble breathing during sleep
• Your child is very sleepy during the day and has trouble staying awake

Book a routine appointment if:

• Loud snoring most nights
• Bedwetting that comes back after being dry
• Behaviour problems or trouble paying attention in school

Diagnosis

A doctor (often a paediatrician or sleep specialist) will ask about your child’s sleep, symptoms, and overall health. They may refer your child for a sleep study to confirm the diagnosis.

Tests that may be done

• Sleep study (polysomnography) – your child spends a night in a sleep lab where sensors monitor breathing, oxygen levels, and sleep patterns.
• Home sleep test – a simpler version for some children, but a full sleep study is often preferred.

What to expect at your appointment

If a sleep study is needed, you’ll stay with your child in a comfortable room. The sensors are painless and are placed on the head, chest, and legs. The test is safe and gives doctors detailed information about your child’s breathing during sleep.

Treatment

Treatment depends on the cause and severity of the sleep apnoea. The goal is to keep the airway open during sleep so your child can breathe normally. Many children do very well with treatment.

Self-care at home

• Help your child maintain a healthy weight if they are overweight – even small weight loss can help.
• Avoid giving your child large meals or sugary drinks close to bedtime.
• Keep the bedroom cool, quiet, and dark to encourage good sleep habits.

Medical treatments

For many children, surgery to remove enlarged tonsils and adenoids (adenotonsillectomy) is the first-line treatment and often cures sleep apnoea. If surgery isn’t possible or doesn’t help enough, a breathing device (such as a CPAP machine) may be used. This device delivers gentle air pressure through a mask to keep the airway open during sleep. Sometimes allergy medicines or nasal sprays are prescribed to reduce congestion. Always follow your child’s doctor’s advice.

When is surgery considered?

Removal of tonsils and adenoids is the most common surgery for children with sleep apnoea caused by enlargement of these tissues. It is usually very effective.

Living with this condition

With treatment, most children with sleep apnoea sleep better, have more energy during the day, and do better at school. You’ll need to follow any treatment plan your doctor recommends, such as using a breathing device at night or preparing for surgery.

Lifestyle tips

• Establish a consistent bedtime routine to help your child relax before sleep.
• Encourage regular physical activity during the day (but not too close to bedtime).
• Limit screen time in the hour before bed.

Diet and exercise

A healthy diet with plenty of fruits, vegetables, and whole grains can help maintain a healthy weight. Regular exercise, such as playing outside or sports, supports good sleep and overall health.

Mental health and emotional wellbeing

Sleep apnoea can cause mood swings, irritability, and trouble focusing – both for the child and for parents who are tired from disrupted sleep. Getting treatment can improve everyone’s well-being. If you notice your child feeling down or anxious, talk to your doctor or school counsellor.

Prevention

It is not always possible to prevent sleep apnoea, especially when it is caused by enlarged tonsils or genetic factors. However, maintaining a healthy weight and treating allergies or nasal congestion may reduce the risk.

Complications

If left untreated

• Poor growth and weight gain
• Behavioural problems and trouble learning at school
• High blood pressure
• Heart problems in severe cases

Long-term outlook

The outlook for children with sleep apnoea is very good. Most children improve significantly with treatment – often after surgery. Early diagnosis and treatment can prevent long-term problems and help your child sleep peacefully and thrive.

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