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Sleep apnea is a breathing disorder that causes a person to stop breathing for brief periods during sleep. Breathing is irregular with repeated stops and starts. The main types of sleep apnea are obstructive sleep apnea and central sleep apnea.
Among pediatric cancer patients, children with brain tumors are at highest risk for sleep apnea. Sleep apnea can make it hard to get enough sleep or have good quality sleep.
Poor quality sleep can cause problems in thinking, emotions, and behavior. Children may have trouble with thinking, attention, or memory and have poor performance at school. In addition, sleep apnea can cause physical problems such as heart problems, high blood pressure, and poor growth.
Nighttime symptoms of sleep apnea include:
Daytime symptoms of sleep apnea:
Sleep apnea is caused by narrowing of the upper airway or throat during sleep. Closing of the airway is more common during sleep because the muscles of the throat and tongue relax. In children, having enlarged tonsils or adenoids is a main cause of sleep apnea. Weight gain and obesity can also contribute to sleep apnea.
Children with brain tumors have a higher risk of sleep apnea compared to children with other types of cancer.
A higher risk of sleep apnea is associated with certain medical conditions including Down syndrome, sickle cell disease, cerebral palsy, and neuromuscular diseases.
Assessment of sleep apnea may include:
Polysomnography is an overnight sleep study to measure sleep behavior and body functions during sleep. Special equipment monitors brain, muscle, heart rate, oxygen levels, and breathing during sleep. Polysomnography is usually done at a sleep medicine center or hospital. Sometimes, a portable sleep monitor may be used at home. The information from a sleep study is used to assess quality of sleep and detect sleep problems.
Treatment of sleep apnea depends on the cause and severity of the condition and age of the child. Some children may have surgery to remove enlarged tonsils or adenoids. This helps keep the throat more open to allow air to pass through more easily.
Continuous Positive Airway Pressure or CPAP is a common treatment for obstructive sleep apnea. CPAP delivers a constant stream of room air (not oxygen) through a mask or nosepiece attached to a machine. The air pressure helps the airways stay open during sleep.
Devices are available that automatically adjust air pressure as needed during sleep. These are called self-adjusting CPAPs, Auto CPAPs, or APAPs.
Lifestyle changes can help reduce sleep apnea and improve sleep:
Reviewed: June 2019