Pediatric Obstructive Sleep Apnea
Obstructive sleep apnea (OSA) in children occurs when a child’s airway repeatedly becomes narrowed or blocked during sleep, causing pauses in breathing. These interruptions disturb healthy sleep quality and can lead to drops in blood oxygen levels throughout the night.
Five Fast Facts
1. Frequent snoring is not harmless or cute. Habitual snoring (≥3 nights/week), especially with gasping, pauses, or persistent mouth breathing, can be signs that your child is struggling to breathe during sleep.
2. Kids with OSA may not look sleepy. In children, symptoms of OSA can mimic (or even worsen!) ADHD symptoms such as hyperactivity, poor focus, or behavioral issues. Disrupted sleep can also cause problems with learning, memory, and mood.
3. Growth problems could signal OSA. Children may show poor weight gain, failure to thrive, or worsening obesity. Overweight children, especially those over >8 years, have a significantly higher risk of moderate to severe OSA.
4. An OSA evaluation differs in kids vs. adults. Kids deserve to have an age-specific sleep evaluation. Diagnostic scoring criteria for OSA in children are more strict due to the importance of healthy sleep in brain development.
5. Pediatric OSA is treatable! Options are tailored to each individual and may include tonsillectomy (if tonsils are enlarged), CPAP, weight management, dental approaches, and allergy treatment.
Red Flags: When To Get Help
Nightime Symptoms
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Pauses in breathing (apnea)
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Gasping or choking during sleep
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Needs to sleep propped up or positioned to breathe better
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Restless sleep, frequent position changes
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Wetting the bed after potty training
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Bruxism (teeth grinding)
Daytime Symptoms
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Hyperactivity or impulsivity
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Trouble concentrating or learning
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Mood swings, irritability
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Difficulty waking up in the morning
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Morning headaches
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Slowed growth, poor weight gain, or gaining weight too fast
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Persistent fatigue or low motivation
Other Risk Factors
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Enlarged tonsils or adenoids
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Persistent allergies, mouth breathing, or frequent nasal congestion
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Facial and airway differences (e.g., small jaw, large tongue)
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Obesity (BMI > 95th percentile)
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History of reflux, asthma, or ADHD
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Strong family history of OSA or snoring
Tools For Parents
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Show your doctor a short video of your child breathing while asleep, including what they typically look like and when they are at their worst.
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Keep a sleep diary for a week or two. Write down your child's bedtime, wake-up time(s), daytime/nighttime symptoms, and things that seem to make symptoms better or worse.
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Ask your pediatric primary care provider: “Does my child need to see a sleep medicine specialist?” You may or may not need a referral to a pediatric-trained sleep medicine specialist (sleepeducation.org) who can order appropriate testing and counsel you about treatment options.