Obstructive Sleep Apnea Can Lead to Heart Problems in Children

Nearly one billion adults worldwide struggle with some form of obstructive sleep apnea, according to a 2019 study. The American Academy of Sleep Medicine notes it can cause increased risk of
stroke and higher risk of death due to heart disease. The organization also notes that children are susceptible to struggling with sleep apnea.

In fact, a new scientific statement seeks to raise awareness of the condition in youngsters. The statement, published in the Journal of the American Heart Association, states that obstructive sleep apnea may adversely impact adolescents’ heart health, and can also lead to issues with high blood pressure. It is critical that parents be aware of what symptoms to watch for, and know how to help their child manage obstructive sleep apnea.

Understanding Obstructive Sleep Apnea

Obstructive sleep apnea, commonly referred to as OSA, occurs when breathing is obstructed during sleep. A blockage in the upper airways disrupts the breathing process as an individual is trying to take a breath.

“When we sleep the muscles in the back of the throat relax, which can lead to collapse and blockage of the upper airway in certain patients,” notes Armeen Poor, MD, a pulmonologist at Metropolitan Hospital Center in New York City and an assistant professor of medicine at New York Medical College.

One 2019 study found that OSA was prevalent in about 9% of children and 44% of obese children. 

There are a number of potential causes of the ailment in children. Small or narrow airways, inflammation blocking the airway, or weak neck muscle tone can lead to OSA. Large adenoids or tonsils can also cause the condition. Children who deal with obesity, sickle cell disease, or were born prematurely may also be more susceptible to sleep apnea.

Race can also be a factor, as African American children are at higher risk of developing OSA. A 2016 study notes that black children are up to six times more likely to struggle with sleep apnea than white children.

Just like with adults, obstructive sleep apnea can detrimentally impact children. “Children with OSA sleep fewer hours and when they are sleeping, they can have low oxygen levels and high carbon dioxide levels throughout the night," says Holly Gooding, MD, Children’s Healthcare of Atlanta and one of the authors of the paper. "This can lead to irritability, behavior changes, school issues, and fatigue during the day."

Sleep apnea can also significantly impact children’s heart health. “OSA results in disrupted sleep, potential cardiovascular problems such as systemic and pulmonary hypertension arrhythmias, and changes in the anatomy and function of the heart," explains Luis Torero, MD, a pediatric pulmonologist with Northwestern Medicine Central DuPage Hospital. "It has been linked to cognitive and behavioral disorders, such as attention deficit hyperactivity disorder."

What Should Parents Watch For?

Understanding the symptoms that point to obstructive sleep apnea can be the first step in getting help for a child. Some of the behaviors can include:

• Continual snoring while sleeping
• Gasping for air during sleep, or pausing while breathing
• Waking up still feeling sleepy, despite getting the adequate amount of rest
• Irritability and moodiness
• Negative changes in academic performance
• Ongoing bed-wetting

A number of treatment options are available, depending on the severity of the child’s sleep apnea. Anti-inflammatory medications can help. If a child struggles with obesity, a change in diet can help lower their weight, which may alleviate OSA issues.

A Continuous Positive Airway Pressure (CPAP) machine can be beneficial, though it can be a challenge sometimes to get children to keep it on. Surgical options, including a tonsillectomy or adenoidectomy, may also bring relief.

Parents should reach out to a child’s pediatrician or a sleep specialist after noticing questionable symptoms.

In addition to seeking appropriate medical advice, parents can also help kids by enforcing consistent bedtimes, and helping to keep the bedroom free of distractions to promote healthy sleep habits.

“OSA in the pediatric population is underappreciated and so learning about the prevalence, presentation, and implications of OSA in children is particularly important," says Dr. Poor. "As more research is done and we learn more about pediatric OSA, we can become better at recognizing and treating it."