Sleep is crucial for a child’s growth, development, and overall well-being. However, many children suffer from sleep-disordered breathing (SDB), a group of breathing disorders that affect airway patency and can disrupt their sleep. SDB encompasses a range of conditions, from frequent loud snoring to obstructive sleep apnea (OSA), where the airway is partially or completely blocked repeatedly during sleep.

When a child’s breathing is disrupted during sleep, the body responds as if the child is choking. This triggers an increase in heart rate, elevated blood pressure, and arousal from sleep. Additionally, oxygen levels in the blood can drop, leading to potentially serious consequences if left untreated.

Symptoms and Consequences of Pediatric SDB
According to studies, approximately 10 percent of children snore regularly, and two to four percent experience OSA. Even mild SDB or snoring can cause problems similar to those associated with OSA in children. Here are some potential symptoms and consequences of untreated pediatric SDB:

  • Snoring: The most obvious symptom is loud snoring on most nights, often interrupted by complete breathing blockages, gasping, and snorting sounds.
  • Irritability and Daytime Sleepiness: Children with SDB may become irritable, sleepy during the day, or have difficulty concentrating at school.
  • Bedwetting: SDB can increase urine production at night, leading to bedwetting (enuresis).
  • Learning and Behavioral Difficulties: Children with SDB may experience mood swings, disruptive behavior, or inability to pay attention at home and school.
  • Slow Growth: SDB can interfere with growth hormone production, resulting in abnormally slow growth and development.
  • Cardiovascular Issues: OSA is associated with an increased risk of high blood pressure and other heart and lung problems.
  • Obesity: SDB may contribute to insulin resistance and decreased physical activity, leading to obesity.

Causes of Pediatric SDB
A common physical cause of airway narrowing and SDB is enlarged tonsils and adenoids. Overweight children are also at increased risk due to fat deposits around the neck and throat that can narrow the airway. Children with abnormalities involving the lower jaw or tongue, or neuromuscular deficits like cerebral palsy, have a higher risk of developing SDB.

Diagnosis and Treatment Options
If you notice any of the symptoms described above, it’s essential to have your child evaluated by an ear, nose, and throat (ENT) specialist or otolaryngologist. Sometimes, a diagnosis can be made based on medical history and physical examination. In other cases, such as children suspected of having severe OSA due to craniofacial syndromes, morbid obesity, neuromuscular disorders, or children under three years old, additional testing like a sleep study (polysomnography) may be recommended.

The most common treatment for pediatric SDB caused by enlarged tonsils and adenoids is surgical removal (tonsillectomy and adenoidectomy). Many children with OSA show significant improvement in sleep and behavior after this procedure. However, not every child with snoring requires surgery, and conservative management may be recommended for mild or intermittent cases.
In some instances, children may have persistent SDB after surgery, and additional treatments such as weight loss, continuous positive airway pressure (CPAP), or further surgical procedures may be necessary.

Questions to Ask Your Doctor

If my child’s tonsils and adenoids are not removed, how will I know it’s safe for them as they approach puberty (when tonsils and adenoids often shrink)?

Is a sleep study required to make a diagnosis, or can it be based on symptoms and examination?

After my child has their tonsils and adenoids removed, will they have any problems with immune function?

Don’t let pediatric sleep-disordered breathing go unaddressed. Call the Center for Orofacial Myology at (208) 793-7006 to schedule a free consultation and learn more about the available treatment options for your child.

By understanding the symptoms, causes, and treatment options for pediatric SDB, you can take proactive steps to ensure your child enjoys restful sleep and optimal growth and development. The Center for Orofacial Myology is here to guide you through this process and provide the necessary support and care!