Sleep apnea is a potentially dangerous condition in which a child stops breathing during sleep for 20 seconds or more, or a shorter period if accompanied by bradycardia (slow heart rate). According to the authors of "Wong's Essentials of Pediatric Nursing", sleep apnea affects 1 to 3 percent of children in the United States, and most often occurs between the ages of 2 to 6 years. Children receive a diagnosis using an overnight sleep test and then receive treatment depending on the cause and severity of symptoms.
Snoring
In the adult population, snoring is usually correlated with being overweight, but in the pediatric population this usually proves untrue. In children, snoring often indicates a sign of airway obstruction. This can result from enlarged tonsils or adenoids, nasal inflammation or congestion caused by allergies or chronic infections.
Disturbed Sleep/Restlessness
During the night, children with sleep apnea often awaken suddenly when they gasp for air. The amount of time a child remains awake during these episodes often proves usually short, but the frequency of which these occurrences (sometimes 15 to 30 times a night) causes restlessness. The effects of disturbed sleep create a marked increase in daytime drowsiness and the inability to concentrate.
Mouth Breathing
Breathing through the mouth presents a common symptom of sleep apnea in children who have nasal obstruction due to inflammation, allergies or anatomical abnormalities. Because air breathed in through the mouth does not warm up as it does when inhaled through the nose, mouth breathing often causes dry mouth and can lead to gum and tooth disease.
Bed-Wetting
Bed-wetting (enuresis) is a common and embarrassing problem for children with sleep apnea. One of the reasons bed-wetting occurs may include the child's arousal response decreases and she won't wake up as readily. In addition, because breathing stops during apnea, the pressure in the abdomen increases (similar to when you hold your breath), and this increase in pressure may push on the bladder, causing a child to wet the bed.
In 2007, the findings of a study testing the correlation between nighttime enuresis (NE) and sleep apnea due to enlarged adenoids and/or tonsils was published in "The Laryngoscope." The study concluded that removing the tonsils and adenoids (adenotonsillectomy) reduced the frequency of NE. The authors stated that, "Postoperatively, 61.4% (35) of the children were free of enuresis, 22.8% (13) had a decrease in enuresis, and 15.8% (9) had no change in enuresis. A chi-square test showed a statistically significant difference among the groups."
References
- "Wong's Essentials of Pediatric Nursing"; Marilyn J. Hockenberry, PhD, RN-CS, PNP, FAAN; 2005.
- "The Laryngoscope"; Effectiveness of Adenotonsillectomy in the Resolution of Nocturnal Enuresis Secondary to Obstructive Sleep Apnea; Suzanne Basha, MD, Christie Bialowas, Kevin Ende, MD, Wasyl Szeremeta, MD, MBA; December 2007.
