Pediatric Sleep Apnea

Symptoms

• Snoring and breathing difficulty during sleep (In infants, however, there is no correlation between the intensity and frequency of snoring and the degree of sleep-disordered breathing. Infants may also not snore at all, but may still have apneas.)
  
• Paradoxical breathing - Due to their more pliant rib cages, children with OSA may show paradoxical breathing, an inward rib cage motion during inspiration. Pectus excavatum (concave chest wall) or thoracic retraction (drawing back of chest) can also sometimes result.
  
• Profuse sweating
  
• Bed-wetting
  
• Unusual sleep positions (for example, seated or with neck hyperextended)
  
• Excessive daytime sleepiness (typical in older children or adolescents, but not younger children)
  
• Cognitive and behavioral problems
  
• Developmental delay
  
• Poor school performance
  
• Attention deficit/hyperactiivity disorder (ADHD)
  
• Aggressive behavior
• Slow rate of growth - In early childhood, OSA can cause growth failure, especially when associated with a genetic or craniofacial disorder. However, children commonly make gains in both height and weight following treatment. Adolescents may be obese.
  
• Morning headaches
  
• Mouth breathing - Because pediatric OSA is often due to enlarged adenoids and tonsils, a child may also breathe through his or her mouth, have frequent upper respiratory tract infections, or have difficulty swallowing.