What causes sleep apnea in children?

Javier A. Hiriart, MD
Internal Medicine
Sleep apnea can occur when there is a blockage in the upper airway that causes low air flow, and pauses in breathing. Tonsils and adenoids that are larger in proportion to a small airway are the most common cause of sleep apnea in children. The oxygen shortage interrupts brainwave activity, which can cause children to become chronically sleep deprived. Being tired is not always the main symptom.

Chronic sleep deprivation in children often manifests as hyperactivity. Children being evaluated for attention deficit hyperactivity disorder (ADHD) should also have a sleep study to diagnose or rule out an underlying sleep disorder, such as sleep apnea.
Douglas Li, MD
Pediatric Pulmonology
Common causes of sleep apnea in children include a facial or airway abnormality, large tonsils and/or adenoids and obesity. A facial or airway abnormality can cause sleep apnea in children shortly after birth or in infancy. As children grow, their tonsils and adenoids (a mass of tissue in the nasal cavity) also grow in size, peaking around 2 to 6 years of age. These enlarged tissues can cause breathing difficulty at that time. Sleep apnea can affect adolescents, particularly if the child is obese. Sleep apnea has both a genetic and environmental component and can occur at any age, depending on the cause.
A child could have been born with a small jaw or a small airway that makes it hard to breathe fully. There's also the possibility that the muscles and the nerves controlling those muscles are not well integrated during sleep and therefore do not open the airway enough. And then there’s the chance that a child has enlarged tonsils and adenoids that prevent normal breathing. This last possibility, in fact, is very common among youngsters. When the problems are significant enough, parents can choose to have their child’s tonsils and adenoids removed. According to the National Center for Health Statistics, more than 263,000 children in the U.S. have tonsillectomies each year and sleep apnea is a major reason.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.