Medical Edge Newspaper Column

How Could A Healthy 6-Year-Old Get Sleep Apnea?

Sept. 5, 2005
DEAR MAYO CLINIC:
I thought sleep apnea was a problem that affected overweight adults. Now my grandchild has been diagnosed with it! What could cause this problem in a skinny, otherwise healthy 6-year-old boy? What are the treatment options? -- Moline, Ill.

ANSWER:
Sleep apnea is fairly common in young children. Studies show that 1 percent to 3 percent of children under 6 have sleep apnea -- a potentially serious condition in which breathing repeatedly stops and starts during sleep.

Obstructive sleep apnea is the most common form of the disorder. During sleep, the muscles in the walls of the throat relax, collapse on themselves and obstruct the flow of air. After a short time, the child arouses briefly, the muscles tighten and relieve the obstruction, and breathing resumes.

Although occasional snoring is harmless, if a child snores on a nightly basis in all sleep positions, it may be a sign of obstructive sleep apnea, particularly if the snoring is punctuated by snorts or gasps. Other nighttime symptoms include breathing through the mouth during sleep and restless sleep. During the day, a child who has sleep apnea may be tired and sluggish, experience mood swings and irritability, suffer from poor concentration and show signs of hyperactivity.

In adults, excessive weight often causes sleep apnea. In children, weight is less of a factor. For kids, the most frequent cause of sleep apnea is enlargement of the tonsils and adenoid glands (tissue in throat or back of the mouth). In rare cases, an abnormality in the formation of the face or a neuromuscular disorder, such as muscular dystrophy, may also cause sleep apnea.

If an evaluation reveals marked enlargement of the tonsils or adenoids, your grandson's physician may recommend they be removed. This eliminates the problem in most cases. If removal of the tonsils or adenoids does not alleviate sleep apnea, or if there is uncertainty about what is causing the disorder, I would recommend a consultation with a sleep disorders specialist. He or she can tailor treatment based on the nature and severity of the problem.

To determine the right treatment, your grandson should first be evaluated by his pediatrician or family physician, who may offer a referral to a sleep disorders specialist. Obstructive sleep apnea in children is a treatable condition, and it's quite likely his physicians can develop a plan that will allow your grandson to get a good night's rest.

-- Suresh Kotagal, M.D., Sleep Disorders Center, Mayo Clinic, Rochester, Minn.