A hallmark sign of obstructive sleep apnea (OSA) is characterized by episodes of complete airway closure or partial collapse that can happen several times a night.

The long-term effects of OSA manifest differently in children versus adults. Here, we’ll look at pediatric symptoms of OSA, the consequences of untreated OSA, and the causes of OSA in children.

Symptoms of OSA In Children ¹

Symptoms of pediatric OSA may include the following during sleep:

• Snoring or mouth breathing
• Nighttime sweating or bedwetting
• Pauses in breathing
• Restless sleep

Symptoms of OSA in infants and young children may include disturbed sleep without snoring.

Daytime symptoms of OSA may include:

• Behavioral problems
• Learning difficulties
• Trouble paying attention
• Hyperactivity
• Poor weight gain

Other indications may also be observed during the course of an examination.

Causes Of OSA In Children

The development of OSA is linked to four key features: obesity, lymphoid hyperplasia, craniofacial abnormalities, and neuromuscular dysfunction ².

Childhood obesity is also becoming an increasingly prevalent risk factor for pediatric OSA. Due to this risk factor, it’s recommended that all children be screened for their BMI at every pediatrician visit. In cases where childhood OSA stems from obesity, fat deposits accumulate around the upper airway, leading to heightened extrinsic pressure and subsequent collapse ³. Although obesity plays a role in OSA for some children, obstructive sleep apnea is predominantly linked to enlarged tonsils and adenoids in children².

For both central and obstructive sleep apnea cases, neuromuscular dysfunctions can be present ².

The final feature linked to OSA in pediatrics is craniofacial abnormalities. Children born with a birth defect linked to the shape of their face or head, including those with Crouzon and Pierre-Robin syndromes, are at an increased risk ².

Effects of Untreated Pediatric Obstructive Sleep Apnea

Long-term obstructive sleep apnea can impact cardiovascular health, mental wellness, and general quality of life. Children who experience untreated OSA may develop behavior problems, cardiovascular issues, metabolic conditions, and other issues ⁴. 

Children suffering from OSA commonly experience disrupted sleep, a factor that can contribute to daytime problems like inattentiveness, difficulty focusing, behavioral and mood problems, and headaches ⁵. When these behaviors are observed, it is common for parents to bring their children to the doctor for an assessment.

During physical examinations, patients may appear tired or demonstrate heightened levels of activity.

If your pediatric patients have enlarged tonsils and are experiencing symptoms of OSA, consider exploring COBLATION Technology for tonsillectomy.

Disclaimer: Smith+Nephew does not provide medical advice. The information presented is not, and is not intended to serve as, medical advice. It is the responsibility of healthcare professionals to determine and utilize the appropriate products and techniques according to their own clinical judgment for each of their patients. The information presented may not be appropriate for all jurisdictions.

1. Mayo Clinic. Pediatric obstructive sleep apnea. Available at: https://www.mayoclinic.org/diseases-conditions/pediatric-sleep-apnea/symptoms-causes/syc-20376196. Accessed March 8, 2024.
2. Schwengel DA, Dalesio NM, Stierer TL. Pediatric obstructive sleep apnea. Anesthesiol Clin. 2014 Mar;32(1):237—61.
3. Jehan S, Zizi F, Pandi-Perumanl S, Wall S, Auguste E, Myers A, Jean-Louis, G, McFarlane S. Obstructive Sleep Apnea and Obesity: Implications for Public Health. Sleep Med Disord. 2017; 1(4).
4. Li Z, Celestin J, Lockey RF. Pediatric Sleep Apnea Syndrome: An Update. J Allergy Clin Immunol Pract. 2016 Sep-Oct;4(5):852—61.
5. Trosman I, Trosman S. Cognitive and Behavioral Consequences of Sleep Disordered Breathing in Children. Medical Sciences, 2017 Dec.