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Why is it the obstructive sleep apnea in kids is different than that of adults?

It’s different; however, kids and adults DO share one thing in common as far as a major risk factor.

If your child exhibits any of the following issues, you should consider the possibility of obstructive sleep apnea.

• Snoring, snorting or gasping during sleep

• Heavy breathing when asleep

• Unusual positions during sleep

• Moving or fidgeting a lot during sleep

• New development of bedwetting

• Dreams about being choked or drowning

• Difficulty awakening for the day

• Daytime sleepiness or fatigue

• Daytime inattentiveness, trouble focusing

• Falling asleep in class

• Recent diagnosis of ADHD

Be very leery if a pediatrician, after examining your child and asking them questions, then announces, “I don’t think he has sleep apnea. I wouldn’t worry about it.”

Only a sleep study can rule out OSA.

A sleep study, during which the patient is fast asleep, will reveal information that a doctor simply cannot observe or detect in the office while the patient is awake. They are:

• Heart rate during sleep

• Eye movements during sleep

• Breathing patterns during sleep

• Brain waves during sleep

• Blood oxygen and carbon dioxide levels during sleep

• Snoring and other sounds

• Sleep positions and body movements

How does childhood OSA differ from that of adult?

“Tonsillar hypertrophy or enlargement, coupled with a loss of upper airway muscle tone in children, are commonly identified as the etiology and mechanism of obstructive sleep apnea in children,” says Joi Lucas, MD, medical director of pediatric pulmonology at Nemours Children’s Clinic and chief of pediatrics, Lakeland Regional Hospital, FL.

“However, obstructive sleep apnea is a complex syndrome with multiple risk factors.

“The major risk factor for OSA shared by adults and children with OSA is obesity.”

It is never okay for a child to be obese.

Obesity in children can choke off their air supply during sleep, since excess fat in the throat can cause airway obstruction when relaxed. Shutterstock/Yuriy Golub

“Obesity” is not a subjective term. It’s a medical term and can be determined by a pediatrician, though physical appearance is often enough to know that a child fits the criteria for medical obesity.

Dr. Lucas also says that “adults with OSA may have complications including hypertension, stroke, myocardial infarction, pulmonary hypertension, chronic inflammation and daytime somnolence.

“While children with OSA can have all or some of the pulmonary and cardiac complications seen in adults — but mostly experience complications of daytime somnolence, behavioral changes, poor school performance, headache, enuresis [bedwetting] and fatigue.

“The reasons for the difference in complications of sleep apnea in adults and children is unclear, but likely is due to increased overall risk for pulmonary and cardiovascular compromise in adults when compared to children.”

Dr. Lucas is double board certified in pediatrics and pediatric pulmonology. She developed the Asthma KidCare Go-Bag, a carrying case and organizer for asthma and allergy medications. Follow her on Facebook, Instagram and Twitter @Dr.JoiMD. 
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer. 

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