Understanding Pediatric Obstructive Sleep Apnea and Why It’s Often Missed

Sleep plays a vital role in a child’s growth, development, and overall health. When a child isn’t sleeping well, the effects can extend far beyond daytime tiredness. One condition that often goes undiagnosed in children is pediatric obstructive sleep apnea (OSA).
 

What Is Pediatric Obstructive Sleep Apnea?

Pediatric OSA occurs when a child’s airway becomes partially or completely blocked during sleep. The obstruction can result from enlarged tonsils or adenoids, a narrow palate, obesity, or jaw development issues that reduce airway size. When airflow is interrupted, oxygen levels drop, and the brain briefly wakes the child to reopen the airway. These repeated disruptions prevent deep, restorative sleep, even if the child appears to sleep through the night.
 

Common Signs and Symptoms

Unlike adults, who often show obvious symptoms such as loud snoring or gasping, children with sleep apnea may display more subtle or behavioral signs.
 

Common symptoms include:
 

•          Snoring, gasping, or pauses in breathing during sleep

•          Mouth breathing, especially at night

•          Restless sleep or frequent awakenings

•          Bedwetting beyond the expected age

•          Difficulty waking up in the morning

•          Daytime sleepiness or fatigue

•          Slower growth or poor weight gain
 

Because these symptoms overlap with other pediatric conditions, such as behavioral or learning disorders, the underlying sleep issue often goes unnoticed.
 

Why Pediatric Sleep Apnea Is Often Missed

Pediatric OSA is frequently underdiagnosed due to several factors:
 

•          Subtle Symptoms: Parents and even healthcare providers may not recognize that behavioral issues or poor school performance stem from disrupted sleep.

•          Misinterpretation of Snoring: Occasional snoring in children is often dismissed as normal, when it can be an early warning sign of airway obstruction.

•          Developmental Misconceptions: Children may not report sleep problems directly, and signs such as restlessness or mouth breathing can be mistaken for normal developmental variations.

•          Lack of Awareness: Pediatric sleep apnea is less well known than adult OSA, so screening during routine checkups is not always performed.
 

How Pediatric OSA Is Diagnosed and Treated

Diagnosis often involves a combination of medical evaluation, sleep studies (polysomnography), and assessment of the airway structure. A board-certified sleep physician plays a key role in this process - interpreting sleep study results, identifying the type and severity of sleep apnea, and coordinating care with other specialists such as ENTs, orthodontists, and myofunctional therapists.
 

Treatment options depend on the underlying cause and severity of the condition and may include:
 

•          Removing enlarged tonsils or adenoids to clear airway obstruction

•          Orthodontic or orthopedic treatment to widen the jaw and improve airflow

•          Continuous Positive Airway Pressure (CPAP) therapy for more severe cases

•          Myofunctional therapy to strengthen oral and airway muscles

•          Lifestyle changes such as weight management, when appropriate

A multidisciplinary approach led by a board-certified sleep physician ensures that each child receives a personalized treatment plan addressing both the medical and structural causes of their sleep-disordered breathing.
 

Give Your Child the Rest They Deserve

Pediatric obstructive sleep apnea is a serious but often overlooked condition that can significantly impact a child’s health, behavior, and development. Recognizing the early signs and seeking professional evaluation are key steps in ensuring healthy sleep and growth.
 

If your child snores, breathes through their mouth, or struggles with daytime focus and fatigue, it could be a sign of an underlying sleep disorder. The team at TMJ & Sleep Therapy Centre of San Diego, in collaboration with board-certified sleep physicians, provides comprehensive evaluation and treatment options to help your child breathe easier and sleep better. Visit our office in La Mesa, California, or call (619) 762-4379 to schedule a pediatric sleep evaluation today.