The distinction between pediatric sleep-disordered breathing and pediatric sleep apnea isn’t always clear to parents and caregivers of children with airway problems. Your child can have sleep-disordered breathing without having sleep apnea. These conditions sometimes lie on a continuum.
- Upper airway resistance syndrome
- Obstructive hypopnea
- Obstructive sleep apnea.
Other times, sleep apnea (obstructive or central) is present without the progression above. And still, your child could have a lesser condition from the above list that never progresses to sleep apnea.
Snoring is the least severe form of pediatric sleep-disordered breathing. Many parents and caregivers find snoring in children cute, but it could mean a partial obstruction in their airway or that their jaws are positioned too far back. The soft tissues in your child’s airway (throat and nasal passages) can sag when sleeping. The snoring sound you hear is air rushing past these sagging soft tissues.
The obstruction can occur in the nose from the tonsils or throat from the tongue and other soft tissues. When a child’s jaw is positioned too far back, the tongue falls back into the airway when it’s relaxed. A child with a correctly set jaw has enough room for the tongue to relax and not get in the way.
Snoring doesn’t usually cause daytime sleepiness or the severe symptoms of sleep apnea. But snoring could progress later in your child’s life.
Upper Airway Resistance Syndrome
Upper airway resistance syndrome (UARS) is more severe than snoring but not as severe as obstructive hypopnea or sleep apnea. The soft tissues in the airway are still sagging, but more so than with snoring, even though snoring is still present. When your child has UARS, daytime symptoms will start to emerge, such as daytime sleepiness, fatigue, and cognitive trouble like memory and concentration.
Yet, UARS is still not sleep apnea because there is no stoppage in breathing at night. Or if there is, it’s very slight and doesn’t happen often or long enough to be classified as childhood obstructive sleep apnea.
Obstructive hypopnea is another sleep condition your child can have where their airway is partially blocked. It can occur due to hypothyroidism, obesity, jaw shape, or the size of their tonsils or adenoids.
Since the obstruction is more severe, the symptoms become more severe too. Children can experience daytime sleepiness, fatigue, mental interruptions, loud snoring, choking and gasping for breath during sleep, morning headaches, mood disturbances, and bedwetting.
Your child’s breathing won’t completely stop with obstructive hypopnea, but they’ll experience 30% less oxygen and take shallow breaths for ten seconds or longer.
Obstructive Sleep Apnea
Obstructive sleep apnea (OSA) is when your child’s airway is blocked. They’ll experience stoppages in breathing for ten seconds or longer, and eventually, their brain will partially awaken them to resume breathing. Not only is the lack of oxygen dangerous for your child’s brain, but they’ll never get through a whole sleep cycle which can also have dangerous consequences.
OSA has the same symptoms as the previous conditions plus more and is more severe. The list below is in addition to those mentioned above. See here for a complete list.
- Poor memory or learning difficulties
- Behavioral problems, including aggression
- “Hyperactivity”—children might be diagnosed ADD/ADHD
- Depression or low mood
- Slow growth
- Mouth breathing
- Restless sleep
- Stoppages in breathing
- Nighttime sweating
- Sleep terrors
Central Sleep Apnea
Central sleep apnea (CSA) causes pauses in breathing while your child sleeps, but it’s not due to a blocked airway. This stoppage in breathing is caused by their brain not communicating with the muscles of the lungs. They’ll experience the same symptoms, including snoring from time to time. CSA is most common in infants and premature babies but can also occur due to a brain injury.
Management is Unique to Each Child
Management for your child could look different than your friend or neighbor’s child and depends on the cause of sleep-disordered breathing. Options for management could include myofunctional therapy, orthodontics, orthopedics, appliance therapy, CPAP, and in rare cases, surgery. Your sleep dentist will evaluate your child’s condition, severity, anatomy, adaptability to management, and your budget to determine the best options. After thoroughly explaining all choices, you’ll collaborate to decide on a management plan.
Get Help from a Sleep Doctor
If you are concerned your child may have any form of pediatric sleep-disordered breathing, seek help right away. If left unmanaged, their lives and future could quickly derail.
ASAP Pathway has sleep dentists worldwide to help your child sleep easily at night and avoid dangerous consequences. Check out our provider map to find a sleep dentist near you.