Obstructive Sleep Apnea OSA |Overview
What is obstructive sleep apnea?
If your child snores or has trouble breathing at night, he or she may not just be a noisy sleeper. It could be a sign of obstructive sleep apnea (OSA), a condition in which breathing is repeatedly blocked during sleep. OSA affects about 2 to 5 percent of children and teenagers.
OSA occurs when the upper airway in the back of the nose or throat is blocked, preventing the normal amount of air from entering the lungs. Sleep apnea involves brief (10- to 20-second) breathing pauses (apneas) that occur often throughout the night. These pauses can lead to a temporary decrease in oxygen levels, which alert the brain there is a problem. The brain then “jump starts” breathing again by waking up the sleeping person. Although breathing resumes, these brief wakings disrupt sleep.
OSA can cause children to be tired, irritable, or hyperactive during the day and to perform below their potential at school.
What are the symptoms of obstructive sleep apnea?
阻塞性睡眠呼吸暂停(OSA)的症状sometimes difficult to detect in children. Children with OSA may not look sleepy, even if they’re not sleeping well. Symptoms of OSA can also vary depending on the child and the severity of the problem.
Common symptoms may include:
- snoring
- breathing pauses during sleep that last about 10 to 20 seconds and often end in a gasp, snore, snort, or sigh
- sleeping with the mouth open or neck extended
- restless sleep
- waking often during the night
- sweating during sleep
- tiredness, moodiness, irritability, or hyperactivity during the day
- difficulty waking in the morning
- dry mouth orheadachesin the morning
- nighttime bed wetting that returns after months or years of the child being dry at night
If you think your child might have OSA, talk with your primary care provider. He or she may refer you to a sleep specialist for a full evaluation andsleep study.
What are the causes of obstructive sleep apnea?
OSA is caused by a blockage of the upper airway in the back of the throat. Common reasons for the blockage include:
- 扩大ment of the tonsils and adenoids (spongy tissues at the back of the throat)
- fat deposits around the upper airway due to being overweight or obese
- allergies,asthma,sinus infections, orgastroesophageal reflux
- certain medical conditions, such asDown syndromeand Prader-Willi syndrome
- craniofacial conditionssuch asPierre Robin sequence,apert syndrome, andCrouzon syndrome
- neuromuscular disorders that affect muscle tone and function, such asmuscular dystrophyandcerebral palsy
How we diagnose obstructive sleep apnea
To help diagnose your child’s condition, the clinician will take a detailed medical history and perform a full physical examination. He or she may also:
- ask questions about your child’s breathing during sleep and any other symptoms he or she is having
- ask you to take a video or keep asleep log. A sleep log tracks how many hours your child sleeps, how many times he or she wakes up, and his or her level of alertness in the morning. A short video of your child sleeping taken on your cell phone can also be very helpful to document your child’s symptoms. If you have already have these, be sure to bring them to your appointment.
What tests are used to diagnose obstructive sleep apnea?
Your clinician may also want to run a few tests to evaluate your child. These may include:
- anx-rayof your child’s upper airway
- apolysomnogram (sleep study)to measure different types of data and record sleep stages, breathing, oxygen levels, heart rate, body movements, and sleep disruptions
How we treat obstructive sleep apnea
Getting care for obstructive sleep apnea can have far-reaching positive effects on your child’s overall health.
If your child has been diagnosed with OSA, there are many effective treatments. These may include:
- weight loss for children who are overweight
- nasal steroids and other medications to reduce nasal congestion, particularly in children who have allergies or asthma
- oral (dental) appliances to open the airway
- using a continuous or bi-level positive airway pressure (CPAP or BiPAP) machine to keep the airway open during sleep
- muscle retraining of the upper airway (myofunctional therapy)
- surgery to remove the tonsils or adenoids (tonsillectomy or adenoidectomy) or to correct any abnormalities in facial structure
How we care for obstructive sleep apnea
At Boston Children’s Hospital, the specialists in ourSleep Centerinclude a team of board-certified clinicians with training in pulmonary medicine, neurology, developmental medicine, otolaryngology (ear, nose, and throat, or ENT), and dentistry. Children whose sleep apnea is caused by enlargement of their adenoids and tonsils are also treated in theDepartment of Otolaryngology and Communication Enhancement.
Obstructive Sleep Apnea OSA |Programs & Services
Departments
Pulmonary Medicine
Department
The Division of Pulmonary Medicine serves children with acute and chronic respiratory conditions.
Otolaryngology and Communication Enhancement
Department
The Department of Otolaryngology and Communication Enhancement provides care for a wide variety of congenital and acquired conditions of the head and neck, ranging from airway obstruction and thyroglossal duct cysts to chronic ear and sinus infections.
Learn more about Otolaryngology and Communication Enhancement
Neurology
Department
The Boston Children’s Hospital Department of Neurology cares for infants, children, and adolescents with all types of neurologic and developmental disorders.
Programs
Sleep Center
Program
We continue to help set the standards of care for sleep problems in children of all ages, from newborns to adolescents.
Intermediate Care Program
Program
Boston Children's Hospital - Intermediate Care Program