Pediatric obstructive sleep apnea (OSA) and snoring
Pediatric obstructive sleep apnea (OSA) is a sleep disorder in which a child’s breathing is partially or completely blocked during sleep.
Overview
Pediatric obstructive sleep apnea (OSA) is a sleep disorder in which a child’s breathing is partially or completely blocked during sleep. This blockage is often caused by enlarged tonsils or adenoids, but may also result from other airway issues. While occasional snoring is common, frequent or loud snoring in children may indicate OSA—a condition that can affect sleep quality, behavior, academic performance and long-term health.
Causes
Common contributors to OSA and snoring in children include:
- Enlarged tonsils and adenoids (most common)
- Large tongue
- Obesity or excess weight
- Nasal obstruction from allergies, congestion or a deviated septum
- Neuromuscular conditions that reduce airway tone
- Craniofacial abnormalities that narrow the airway
Diagnosis
A thorough evaluation helps determine the cause and severity of sleep-disordered breathing. Diagnosis may include:
- A review of your child’s medical and sleep history
- Physical exam of the throat, nose and airway
- Polysomnography (sleep study)—the gold standard for diagnosing OSA, which measures breathing, oxygen levels and sleep patterns overnight
Long-Term Effects of Untreated OSA
Without treatment, pediatric OSA can lead to:
- Learning or behavioral difficulties
- Growth delays and developmental issues
- High blood pressure or strain on the heart
- Chronic fatigue and poor school performance
When to Seek Medical Evaluation
Schedule an appointment with one of our specialists if your child:
- Snores loudly most nights
- Has pauses or struggles to breathe during sleep
- Shows signs of hyperactivity, poor focus or other daytime behavioral changes
Experiences restless sleep or persistent mouth breathing
Common symptoms
Common symptoms for children with sleep-disordered breathing may experience:
- Loud, persistent snoring
- Pauses in breathing during sleep
- Choking or gasping during sleep
- Restless sleep or frequent awakenings
- Mouth breathing, especially at night
- Bedwetting beyond the typical age
- Morning headaches or dry mouth
- Daytime sleepiness, hyperactivity or attention difficulties
Specialty care
Treatment options
1. Tonsillectomy and adenoidectomy
For most children, enlarged tonsils and adenoids are the primary cause of OSA. A surgery can significantly improve and often resolve sleep apnea symptoms.
2. Medical management
For mild cases or children not suited for surgery, treatment may include:
- Nasal steroid sprays or leukotriene inhibitors to reduce airway inflammation
- Allergy management to improve nasal breathing
- Positioning changes during sleep (laying on the side or stomach)
3. Continuous positive airway pressure (CPAP)
In moderate to severe cases where symptoms persist after surgery or medication trial, CPAP therapy may be recommended. CPAP uses gentle air pressure delivered through a mask to keep the airway open during sleep.
4. Orthodontic or ENT evaluation
In select cases, jaw or airway anatomy may contribute to airway obstruction. Collaboration with orthodontists or ENT specialists can help address these structural factors.
