Sleep Apnea

What is sleep apnea?

Sleep apnea is a sleep disorder that causes pauses in breathing during sleep. Breathing may stop and start many times through the night. Sleep apnea can affect people of all ages, including children and teens. 

The 2 main types are obstructive sleep apnea and central sleep apnea: 

• Obstructive sleep apnea (OSA): Happens when the throat or upper airway becomes narrow or closes during sleep. This is the most common type of sleep apnea. 
• Central sleep apnea: Happens when the brain does not send the correct signals to the muscles that control breathing. 

Sleep apnea can make it hard to get enough good-quality sleep. Poor sleep can affect thinking, emotions, and behavior. Children may have trouble with attention and memory. They may have learning challenges at school. Sleep apnea can cause physical problems such as heart problems, high blood pressure, and poor growth. 

Sleep apnea may be treated with surgery or continuous positive airway pressure (CPAP) to keep the airway open during sleep. Other ways to manage sleep apnea include:  

• Medicines that help with breathing  
• Weight-control strategies 
• Other treatments to keep the airway open 

Read about other sleep disorders.

Symptoms of sleep apnea

Nighttime symptoms of sleep apnea

Signs and symptoms of sleep apnea in children at night may include: 

• Loud snoring 
• Breathing that stops and starts 
• Gasping for air, choking, coughing, or snorting 
• Heavy breathing 
• Mouth breathing during sleep 
• Restlessness during sleep 
• Sweating 

Daytime symptoms of sleep apnea 

Signs and symptoms of sleep apnea in children during the day may include: 

• Morning headaches 
• Mouth breathing  
• Feeling tired or sleepy (Young children may not seem sleepy.) 
• Mood changes, acting cranky 
• Problems with thinking, attention, or memory 
• Problems or not doing well at school or work 
• Trouble sitting still 

Causes of sleep apnea

Obstructive sleep apnea happens when the throat or upper airway narrows or closes during sleep as muscles relax.  

Central sleep apnea happens when something interferes with brain signals that control breathing.  

Sleep apnea may be caused by:  

• Enlarged tonsils or adenoids. This is the most common cause of sleep apnea in children. The adenoids are small areas of tissue that sit high behind the nose. The tonsils are oval‑shaped pieces of tissue at the back of the mouth. 
• Weight gain or obesity  
• Certain cancers. Children with brain tumors have a higher risk of sleep apnea compared to children with other types of cancer. 

Other health conditions, including: 

• Down syndrome 
• Sickle cell disease 
• Cerebral palsy 
• Neuromuscular (muscle and nerve) diseases 

Diagnosis of sleep apnea

To diagnose sleep apnea, your child’s care provider may:

• Review your child’s health history and do a physical exam
• Ask questions or use a questionnaire to learn more about symptoms 
• Order tests for sleep apnea

Tests for sleep apnea

A sleep study (polysomnogram) is the most common test for sleep apnea. It is an overnight test that looks at how the body functions during sleep. It can check sleep quality and identify sleep problems. 

The test usually takes place in a sleep lab, where trained staff watch your child while they sleep. Small sensors are gently placed on your child’s body to check breathing, heart rate, oxygen levels, and brain activity. Sometimes, the test is done at home using a portable sleep monitor. 

Treatment of sleep apnea

Treatment of sleep apnea depends on its cause, severity, and your child’s age. Treating sleep apnea helps children breathe properly during sleep. Healthy sleep supports brain function, growth, and overall physical health. 

Surgery 

Treatment may include surgery to remove your child’s tonsils and/or adenoids. This helps keep the throat more open, allowing air to pass through more easily. 

Continuous positive airway pressure (CPAP)  

A continuous positive airway pressure (CPAP) machine is a common treatment for obstructive sleep apnea. A CPAP machine provides a constant stream of room air (not oxygen) through a mask or nosepiece. The air pressure helps the airway stay open during sleep. 

Some devices automatically adjust air pressure as needed during sleep. These are called self-adjusting CPAPs, auto CPAPs, or APAPs.

Prognosis for sleep apnea

With treatment, symptoms and health problems from sleep apnea usually get better. 

How to manage sleep apnea

Your care team can recommend treatments based on the type and cause of sleep apnea and your child’s age. Ways to help manage sleep apnea may include: 

• Maintaining a healthy weight or losing weight, if recommended by your care team 
• Treating allergies and asthma 
• Lifestyle changes, including regular exercise and healthy sleep habits 
• Using a dental device or oral appliance (available from a dentist) to position the tongue or jaw to keep the airway open 
• Using a CPAP machine or extra oxygen during sleep, if prescribed   
• Medicines to stimulate breathing (central sleep apnea) or decrease nasal congestion (obstructive sleep apnea) 
• Avoiding alcohol, smoking, and vaping 
• Avoiding sedative medicines unless prescribed 
• Sleeping on the side instead of the back 
• Using a wedge pillow to raise the head and upper body 

Always follow your care team’s recommendations to help keep your child safe. 

Questions to ask your care team

• What type of sleep apnea does my child have?  
• What is causing my child’s sleep apnea?  
• How serious is my child’s sleep apnea?  
• Does my child need a sleep study or other tests? If so, what should we expect?  
• What treatment options are available for sleep apnea?  
• Will my child need surgery, a CPAP machine, or another treatment?  
• How will treatment help my child sleep and feel better?  
• Are there things we can do at home to help improve my child’s sleep?  
• What symptoms should we watch for that mean my child needs care right away?  

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