Obstructive Sleep Apnea in Children

Sleep-disordered breathing can occur at any age, including infancy, though children are more likely to have problems from age two through eight, with enlarged adenoids being a major contributing cause. Among middle school children and adolescents, the dramatic rise in childhood obesity is resulting in a corresponding increase in the incidence of obstructive sleep apnea.

The rise of obstructive sleep apnea in children and adolescents is particularly troubling because of its impact on the capacity to learn:

  • More than 25 percent of high school students fall asleep in school each week.
  • 22 percent fall asleep doing their homework.
  • 14 percent arrive late or miss school because of oversleeping.
  • Adolescents who get insufficient amounts of sleep are more likely to get lower grades.
  • 55 percent of all motor vehicle accidents are caused by teens.

Risk Factors

A number of factors put children at increased risk for obstructive sleep apnea. Parents and other caregivers should pay particular attention to snoring (children shouldn’t snore!), bed-wetting (40 percent of obstructive sleep apnea patients continue to wet the bed after two years of age), attention deficit hyperactive disorder (ADHD) and nocturnal teeth grinding. Other risk factors include:

  • Down syndrome
  • Decrease in upper airway size
  • Low birth weight
  • Family history
  • Narrow dental arches
  • Small teeth
  • Small, receding lower jaw
  • Mouth breathing
  • History of allergies/asthma
  • Mid-facial hypoplasia (bug-eyed appearance, with a pronounced under-bite)
  • Enlarged tonsils or adenoids
  • Hyperactivity, poor impulse control
  • Attention span challenges
  • Shyness/social problems
  • Learning issues
  • Aggression
  • Gasping or choking
  • Restless sleep
  • Sweating
  • Seizures
  • Autism

Sleep Needs by Age

Infants 4-11 months
Toddlers 1-2 years
Preschoolers 3-5 years
School-aged Children 6-13 years
12 to 15 hours
11 to 14 hours
10 to 13 hours
9 to 11 hours
May be appropriate
10 to 11 hours 16 to 18 hours
9 to 10 hours 15 to 16 hours
8 to 9 hours 14 hours
7 to 8 hours 12 hours